CMS Formulary

Displaying 92241-92250 of 1611142 results.
ID: 92241
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 835564
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92242
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 835568
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92243
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197739
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92244
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 861156
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92245
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 896758
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92246
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 896762
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92247
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 199369
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92248
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 861164
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92249
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 861171
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92250
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 645037
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30