CMS Formulary

Displaying 92121-92130 of 1611142 results.
ID: 92121
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 309289
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 92122
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 309291
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 19
Qty Limit Days: 30
ID: 92123
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 895487
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92124
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 895987
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92125
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 797274
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92126
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 310982
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 30
ID: 92127
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 313189
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 92128
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 309290
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 92129
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197362
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92130
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 313852
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0