CMS Formulary

Displaying 94801-94810 of 1611142 results.
ID: 94801
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 310169
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94802
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 861657
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94803
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 486148
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94804
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 486152
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94805
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 486146
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94806
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 577057
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 94807
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 886634
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 28
ID: 94808
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437702
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30
ID: 94809
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 211343
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94810
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 857002
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30