CMS Formulary

Displaying 95071-95080 of 1611142 results.
ID: 95071
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1651275
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 95072
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1664321
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 95073
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667882
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 95074
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665369
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 95075
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1664328
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 95076
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1664325
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 95077
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1546083
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 95078
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796091
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 95079
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796096
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 95080
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862688
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30