CMS Formulary

Displaying 96081-96090 of 1611142 results.
ID: 96081
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1313885
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96082
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 577237
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96083
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 310285
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96084
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 198359
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96085
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 389242
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96086
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 204119
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96087
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2287905
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 96088
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2056700
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 96089
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1358775
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96090
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 751884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0