CMS Formulary

Displaying 95941-95950 of 1611142 results.
ID: 95941
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 993755
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4500
Qty Limit Days: 30
ID: 95942
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 197448
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95943
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923432
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95944
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 578018
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95945
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 477391
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95946
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 197877
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 95947
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010739
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95948
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 391937
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95949
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 197305
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 95950
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 313786
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0