CMS Formulary

Displaying 96191-96200 of 1611142 results.
ID: 96191
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 213510
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96192
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 310386
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96193
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 199148
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96194
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 311787
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96195
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1605088
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96196
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 199370
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96197
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 197511
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96198
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 309309
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96199
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 197512
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96200
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373333
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0