CMS Formulary

Displaying 92451-92460 of 1611142 results.
ID: 92451
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 858817
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92452
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 858810
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92453
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 308973
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92454
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 858824
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92455
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 858828
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92456
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 308976
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92457
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 834348
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92458
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1370767
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 92459
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 310379
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92460
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 310380
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0