CMS Formulary

Displaying 92601-92610 of 1611142 results.
ID: 92601
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 314214
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 92602
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 312835
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 92603
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 314215
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 92604
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 312836
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 92605
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 311277
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 92606
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099563
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92607
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 904932
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 92608
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 313758
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92609
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 199655
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92610
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 349208
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0