CMS Formulary

Displaying 92961-92970 of 1611142 results.
ID: 92961
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 308720
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92962
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1605071
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92963
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1605075
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92964
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 314072
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 92965
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 244967
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92966
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 309680
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92967
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 309679
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92968
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1376336
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92969
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 204874
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92970
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 313415
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0