CMS Formulary

Displaying 95181-95190 of 1611142 results.
ID: 95181
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 584414
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 95182
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 857297
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95183
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 857301
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95184
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 857305
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95185
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1596780
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 95186
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 855292
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95187
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 855306
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95188
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 855316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95189
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 855322
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95190
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 855328
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0