CMS Formulary

Displaying 94521-94530 of 1611142 results.
ID: 94521
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 977840
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 94522
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 897126
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 94523
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2398842
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 94524
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1991311
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 94525
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1991317
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 94526
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200654
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 94527
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200658
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 94528
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200650
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 94529
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653204
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 94530
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 351926
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28