CMS Formulary

Displaying 95041-95050 of 1611142 results.
ID: 95041
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 313472
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 95042
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 198153
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95043
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 905269
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95044
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 905283
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95045
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 198152
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95046
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 312615
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95047
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 197365
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95048
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 197366
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95049
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 197363
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95050
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 197364
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0