CMS Formulary

Displaying 92171-92180 of 1611142 results.
ID: 92171
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046585
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 92172
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 403878
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 92173
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098143
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92174
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200174
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 92175
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200177
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 92176
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200180
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 92177
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200183
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 92178
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2167575
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 92179
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2167563
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 92180
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2167567
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30