CMS Formulary

Displaying 95011-95020 of 1611142 results.
ID: 95011
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 315107
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 95012
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 310489
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 95013
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 250344
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95014
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 722122
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 95015
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 722116
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 95016
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 198250
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95017
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 197502
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95018
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 863559
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95019
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1431286
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 95020
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 897612
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0