CMS Formulary

Displaying 92691-92700 of 1611142 results.
ID: 92691
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 999967
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92692
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 999996
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92693
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 999986
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92694
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000001
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92695
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 999991
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92696
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 984082
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92697
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551923
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 92698
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601373
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 92699
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1654079
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92700
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 853354
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0