CMS Formulary

Displaying 95321-95330 of 1611142 results.
ID: 95321
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 309079
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95322
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1438778
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95323
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1440937
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95324
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1440183
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95325
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1537209
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95326
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95327
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1539953
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95328
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1539955
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95329
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1605086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95330
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 904419
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30