CMS Formulary

Displaying 95871-95880 of 1611142 results.
ID: 95871
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 349194
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 95872
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 349195
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 95873
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 349198
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 95874
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 403825
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 95875
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 312439
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95876
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 198103
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95877
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 250820
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 95878
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 858751
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95879
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 858733
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95880
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 848943
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0