CMS Formulary

Displaying 94881-94890 of 1611142 results.
ID: 94881
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433250
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94882
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433223
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 94883
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433229
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 94884
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433235
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 94885
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433241
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 94886
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307309
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 94887
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2052609
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94888
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2052704
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94889
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105817
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 94890
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300797
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0