CMS Formulary

Displaying 95211-95220 of 1611142 results.
ID: 95211
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102717
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 95212
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102713
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 95213
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102715
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 95214
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2475840
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 560
Qty Limit Days: 28
ID: 95215
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2107621
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 95216
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 348506
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95217
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719862
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95218
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719803
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95219
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 866103
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 95220
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 672567
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30