CMS Formulary

Displaying 92401-92410 of 1611142 results.
ID: 92401
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2359344
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 21
ID: 92402
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2359348
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 21
ID: 92403
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2359340
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 21
ID: 92404
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2361300
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 92405
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2361296
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 92406
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2174390
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 92407
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243052
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 92408
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1606866
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 92409
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2257013
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28
ID: 92410
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1606870
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28