CMS Formulary

Displaying 92271-92280 of 1611142 results.
ID: 92271
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 403840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92272
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 207364
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92273
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1146690
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92274
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 577776
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92275
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486687
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92276
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197797
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92277
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197726
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92278
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 851750
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92279
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 860225
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92280
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1430383
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0