CMS Formulary

Displaying 92491-92500 of 1611142 results.
ID: 92491
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 903697
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92492
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 903703
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92493
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 313195
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92494
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198240
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92495
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 748865
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92496
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 749848
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92497
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 753544
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92498
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 750244
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92499
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806177
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 92500
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806185
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30