CMS Formulary

Displaying 94891-94900 of 1611142 results.
ID: 94891
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300803
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94892
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 967388
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94893
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 307730
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94894
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 106302
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94895
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 884308
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 94896
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 106387
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94897
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 308714
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 94898
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 755497
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94899
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 992765
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94900
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 630208
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30