CMS Formulary

Displaying 95541-95550 of 1611142 results.
ID: 95541
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 859419
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 95542
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 199192
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95543
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 199193
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95544
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 198382
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95545
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 997226
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 95546
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 997220
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 95547
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 349201
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95548
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 200034
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 95549
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 312078
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 95550
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 314154
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30