CMS Formulary

Displaying 92851-92860 of 1611142 results.
ID: 92851
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1020065
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 92852
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1048445
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92853
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 855626
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 92854
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 855194
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92855
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607617
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 92856
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 311345
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92857
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 198200
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92858
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 349514
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 92859
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 351256
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92860
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 351257
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0