CMS Formulary

Displaying 92081-92090 of 1611142 results.
ID: 92081
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 207836
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92082
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 796918
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92083
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649996
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 92084
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650004
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 92085
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 582984
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92086
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122661
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92087
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122659
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92088
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122657
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92089
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122655
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92090
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122650
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0