CMS Formulary

Displaying 94931-94940 of 1611142 results.
ID: 94931
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 311166
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94932
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 197832
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94933
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 349196
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 94934
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 349197
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 94935
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 905516
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 94936
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 905495
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 94937
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 835913
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94938
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000405
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94939
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 995232
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 94940
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 977883
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0