CMS Formulary

Displaying 92981-92990 of 1611142 results.
ID: 92981
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719766
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 92982
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667666
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 92983
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667670
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 92984
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667674
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 92985
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667678
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 92986
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1741747
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92987
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809471
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92988
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243346
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92989
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243326
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 92990
Formulary ID: 00021036
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243330
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0