CMS Formulary

Displaying 92681-92690 of 1611142 results.
ID: 92681
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 866514
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92682
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 476809
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92683
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197499
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92684
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197500
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92685
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198105
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92686
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198104
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92687
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1662285
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92688
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 205329
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 92689
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 205330
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 92690
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 205331
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30