CMS Formulary

Displaying 95101-95110 of 1611142 results.
ID: 95101
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 861424
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95102
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1047040
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95103
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1047041
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95104
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1727569
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95105
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2171002
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95106
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 403920
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95107
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 312068
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95108
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 314152
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95109
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 312071
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95110
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 859867
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0