CMS Formulary

Displaying 96131-96140 of 1611142 results.
ID: 96131
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 856460
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96132
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 856481
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96133
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 860654
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96134
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 866144
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96135
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 199450
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 96136
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 246172
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 96137
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1606337
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 96138
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 313498
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96139
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 313499
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96140
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 313496
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0