CMS Formulary

Displaying 92431-92440 of 1611142 results.
ID: 92431
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 861487
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92432
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992281
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92433
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 203088
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 92434
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 313227
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92435
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 857366
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 170
Qty Limit Days: 30
ID: 92436
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 313226
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92437
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 308715
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 92438
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 848208
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92439
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 848176
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92440
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 848178
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0