CMS Formulary

Displaying 95061-95070 of 1611142 results.
ID: 95061
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1430457
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 95062
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1100706
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 95063
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1430449
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 95064
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1592748
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 95065
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1592752
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 95066
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243033
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 95067
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243040
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 95068
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243026
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 95069
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1545664
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 95070
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1545668
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30