CMS Formulary

Displaying 92461-92470 of 1611142 results.
ID: 92461
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1313112
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92462
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1370770
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 92463
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 855671
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92464
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 311679
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92465
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 105583
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92466
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 199378
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92467
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 402505
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92468
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 402506
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92469
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1313885
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92470
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 577237
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0