CMS Formulary

Displaying 92591-92600 of 1611142 results.
ID: 92591
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 312084
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92592
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198051
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92593
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 312077
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 92594
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 313412
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92595
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 313413
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92596
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 314286
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 92597
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 313776
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 92598
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 313777
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 92599
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 313778
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 92600
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 994005
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30