CMS Formulary

Displaying 94791-94800 of 1611142 results.
ID: 94791
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 810096
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 94792
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 749761
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 94793
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 748868
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94794
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 759743
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94795
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 748806
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94796
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 748804
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94797
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 310404
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94798
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 310405
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94799
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 284191
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94800
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 359697
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0