CMS Formulary

Displaying 95271-95280 of 1611142 results.
ID: 95271
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 283672
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 95272
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 200371
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 95273
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 309314
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 95274
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 859044
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95275
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 859048
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95276
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 317110
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95277
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 402698
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95278
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 402696
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95279
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 402695
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95280
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 351249
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0