CMS Formulary

Displaying 92651-92660 of 1611142 results.
ID: 92651
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648162
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92652
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648160
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92653
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2048718
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 92654
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2048722
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 92655
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1991509
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92656
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1865962
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92657
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197699
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92658
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 197700
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92659
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 596926
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 92660
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 596930
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30