CMS Formulary

Displaying 92581-92590 of 1611142 results.
ID: 92581
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 199148
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92582
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 311787
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92583
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1605088
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92584
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 199370
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92585
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197511
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92586
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 309309
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92587
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197512
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92588
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373333
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92589
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373335
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92590
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373337
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0