CMS Formulary

Displaying 92321-92330 of 1611142 results.
ID: 92321
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2390946
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92322
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058950
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92323
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058946
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92324
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1722376
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 63
Qty Limit Days: 28
ID: 92325
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2100099
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 180
ID: 92326
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2100100
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 180
ID: 92327
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 312614
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92328
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 283077
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92329
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 993755
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4500
Qty Limit Days: 30
ID: 92330
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197448
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0