CMS Formulary

Displaying 92801-92810 of 1611142 results.
ID: 92801
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2288433
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92802
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2288412
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 92803
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2288431
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92804
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 727816
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 92805
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650901
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 92806
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054995
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 7
Qty Limit Days: 7
ID: 92807
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123137
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28
ID: 92808
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123141
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 92809
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123145
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 92810
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1102277
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0