CMS Formulary

Displaying 95771-95780 of 1611142 results.
ID: 95771
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 259306
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95772
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799654
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95773
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 105292
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95774
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1943345
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95775
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053458
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95776
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 199592
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 95777
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 483090
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95778
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 476399
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95779
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 476515
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95780
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 805464
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28