CMS Formulary

Displaying 92521-92530 of 1611142 results.
ID: 92521
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 860654
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92522
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 866144
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92523
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 199450
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 92524
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 246172
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 92525
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1606337
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 92526
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 313498
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92527
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 313499
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92528
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 313496
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92529
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111110
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 10
ID: 92530
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2279847
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 10