CMS Formulary

Displaying 94601-94610 of 1611142 results.
ID: 94601
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 312134
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 94602
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 198059
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 94603
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 198033
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94604
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 197444
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94605
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 197445
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94606
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 197816
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94607
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 197815
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94608
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1001004
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94609
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 351264
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 94610
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 904605
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0