CMS Formulary

Displaying 94511-94520 of 1611142 results.
ID: 94511
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 213442
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 94512
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860172
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 28
ID: 94513
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2206092
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 94514
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2206099
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 94515
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049380
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 94516
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986354
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 94517
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986356
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 94518
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2205454
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 94519
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653198
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 94520
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 977842
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28