CMS Formulary

Displaying 92511-92520 of 1611142 results.
ID: 92511
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 312839
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 92512
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 312837
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 92513
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091341
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 92514
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359124
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92515
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 403884
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92516
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 310599
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92517
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 856535
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92518
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 856569
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92519
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 856460
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92520
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 856481
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0