CMS Formulary

Displaying 95231-95240 of 1611142 results.
ID: 95231
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1540356
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95232
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 992475
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95233
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 995258
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95234
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1297753
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95235
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1297757
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95236
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 310992
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 95237
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049621
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 95238
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2101899
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95239
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049683
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 95240
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049686
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30