CMS Formulary

Displaying 92411-92420 of 1611142 results.
ID: 92411
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053519
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 92412
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2166401
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 92413
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999389
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 92414
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812470
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 92415
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1655934
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 92416
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053512
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 92417
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 904447
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 28
ID: 92418
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 904158
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92419
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 861495
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92420
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 861448
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0