CMS Formulary

Displaying 94641-94650 of 1611142 results.
ID: 94641
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 800812
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94642
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1189640
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94643
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 800933
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94644
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001321
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 94645
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091843
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 94646
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 402091
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 94647
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986819
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 94648
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2289424
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 94649
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2289428
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 94650
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1942485
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30