CMS Formulary

Displaying 95371-95380 of 1611142 results.
ID: 95371
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 856762
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95372
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 856773
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95373
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 429503
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95374
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 310798
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95375
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 197770
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95376
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 309362
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95377
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 198223
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95378
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 856364
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95379
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 863636
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95380
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 863619
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0