CMS Formulary

Displaying 92151-92160 of 1611142 results.
ID: 92151
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 798133
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92152
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 884520
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 92153
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 755470
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92154
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 544452
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92155
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 597768
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92156
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 597770
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92157
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 597772
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92158
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 403975
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92159
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 259306
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92160
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799654
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0