CMS Formulary

Displaying 92471-92480 of 1611142 results.
ID: 92471
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 310285
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92472
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198359
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92473
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 389242
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92474
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 204119
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92475
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2287905
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 92476
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2056700
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 92477
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1358775
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92478
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 751884
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92479
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1011081
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92480
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 700408
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0