CMS Formulary

Displaying 92641-92650 of 1611142 results.
ID: 92641
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649964
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92642
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 993456
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 180
ID: 92643
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1046402
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92644
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649491
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92645
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649495
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92646
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2168596
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92647
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2045638
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 92648
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2120195
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 92649
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123191
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 92650
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 727537
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0