CMS Formulary

Displaying 96091-96100 of 1611142 results.
ID: 96091
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1011081
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96092
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 700408
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96093
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1112687
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 96094
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 197654
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 96095
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 748879
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96096
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 238153
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 96097
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 359385
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96098
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 834768
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96099
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 835956
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96100
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 748859
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0