CMS Formulary

Displaying 92501-92510 of 1611142 results.
ID: 92501
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2468058
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92502
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2471314
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92503
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653433
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92504
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 748962
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92505
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 831533
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92506
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 993943
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 92507
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 994239
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 92508
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 312138
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92509
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1012904
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92510
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010696
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0