CMS Formulary

Displaying 95171-95180 of 1611142 results.
ID: 95171
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 403923
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 95172
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 241946
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 95173
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 198322
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95174
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 308962
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95175
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 849395
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95176
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 991039
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95177
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 991194
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95178
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 991336
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95179
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 991044
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95180
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 991188
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0