CMS Formulary

Displaying 92711-92720 of 1611142 results.
ID: 92711
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1994362
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 92712
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1442992
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 92713
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000023
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 92714
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000027
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 92715
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000031
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 92716
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300386
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92717
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 829989
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92718
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 830552
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92719
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 830557
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92720
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 803371
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0