CMS Formulary

Displaying 92131-92140 of 1611142 results.
ID: 92131
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 106336
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 92132
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 543460
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92133
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197574
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 92134
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197575
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 92135
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 358917
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92136
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 309333
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 92137
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992273
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92138
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 477451
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 92139
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 855168
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92140
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198245
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0