CMS Formulary

Displaying 96111-96120 of 1611142 results.
ID: 96111
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806177
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 96112
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806185
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 96113
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2468058
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96114
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2471314
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96115
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653433
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96116
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 748962
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96117
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 831533
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96118
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 993943
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 96119
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 994239
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 96120
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 312138
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0