CMS Formulary

Displaying 92361-92370 of 1611142 results.
ID: 92361
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 858053
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 92362
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2059017
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 92363
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1232084
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 92364
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1232088
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 92365
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114202
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 92366
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1549683
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92367
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650968
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 84
ID: 92368
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650972
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 92369
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650974
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 92370
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650976
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 84