CMS Formulary

Displaying 95091-95100 of 1611142 results.
ID: 95091
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 197426
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 95092
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 859315
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 95093
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049635
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 95094
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 198086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95095
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 199167
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95096
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 199164
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95097
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 763181
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95098
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 763179
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95099
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 763185
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95100
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 763183
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0