CMS Formulary

Displaying 96201-96210 of 1611142 results.
ID: 96201
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373335
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96202
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373337
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96203
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 312084
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96204
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 198051
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96205
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 312077
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 96206
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 313412
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96207
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 313413
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96208
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 314286
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 96209
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 313776
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 96210
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 313777
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30