CMS Formulary

Displaying 92031-92040 of 1611142 results.
ID: 92031
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 993503
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92032
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 993518
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92033
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1423080
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92034
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 898723
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92035
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 898687
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92036
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 898690
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92037
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 898719
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92038
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1100184
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 92039
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 857169
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92040
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 857183
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0