CMS Formulary

Displaying 92871-92880 of 1611142 results.
ID: 92871
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 309337
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92872
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197388
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92873
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197980
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92874
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 544455
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92875
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 617322
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92876
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 863599
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92877
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 995241
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92878
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 309686
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92879
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 312055
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 92880
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085745
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0