CMS Formulary

Displaying 92741-92750 of 1611142 results.
ID: 92741
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547231
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92742
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110618
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 92743
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114074
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 92744
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114096
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 92745
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 903841
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92746
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114470
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 92747
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049504
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 92748
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049545
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 92749
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049565
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 92750
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049576
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30