CMS Formulary

Displaying 92481-92490 of 1611142 results.
ID: 92481
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1112687
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 92482
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197654
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 92483
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 748879
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92484
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 238153
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 92485
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 359385
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92486
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 834768
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92487
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 835956
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92488
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 748859
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92489
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 751875
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92490
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 903456
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0