CMS Formulary

Displaying 92421-92430 of 1611142 results.
ID: 92421
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 309370
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92422
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 315059
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 92423
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 103457
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92424
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197407
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92425
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 310364
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92426
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 238920
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92427
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 349351
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92428
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 204135
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92429
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1370754
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92430
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1370750
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0