CMS Formulary

Displaying 92561-92570 of 1611142 results.
ID: 92561
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1811182
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 92562
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649405
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92563
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 852920
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92564
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 313096
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92565
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198224
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92566
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 318179
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92567
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 283535
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92568
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 858778
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 92569
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198222
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92570
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198150
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0