CMS Formulary

Displaying 92861-92870 of 1611142 results.
ID: 92861
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 310261
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92862
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 308459
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92863
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 141963
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92864
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198317
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 92865
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198318
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 92866
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000126
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 92867
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000153
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 92868
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198232
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92869
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 311727
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92870
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 317128
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0