CMS Formulary

Displaying 92141-92150 of 1611142 results.
ID: 92141
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1540241
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92142
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597076
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 92143
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 992441
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92144
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 992454
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92145
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1053753
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92146
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006688
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92147
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 861434
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92148
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197785
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92149
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197803
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92150
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 861490
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0