CMS Formulary

Displaying 96031-96040 of 1611142 results.
ID: 96031
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 861495
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96032
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 861448
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96033
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 309370
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96034
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 315059
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 96035
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 103457
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96036
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 197407
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96037
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 310364
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96038
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 238920
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96039
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 349351
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96040
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 204135
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0