CMS Formulary

Displaying 96041-96050 of 1611142 results.
ID: 96041
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1370754
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96042
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1370750
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96043
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 861487
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96044
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992281
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96045
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 203088
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 96046
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 313227
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96047
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 857366
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 170
Qty Limit Days: 30
ID: 96048
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 313226
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96049
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 308715
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 96050
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 848208
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0