CMS Formulary

Displaying 92771-92780 of 1611142 results.
ID: 92771
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602604
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 92772
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602607
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 92773
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2274816
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 92774
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2274814
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 92775
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044355
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 92776
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044357
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 92777
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044969
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 92778
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044967
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 92779
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044971
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 92780
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649961
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30