CMS Formulary

Displaying 96211-96220 of 1611142 results.
ID: 96211
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 313778
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 96212
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 994005
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 96213
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 314214
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 96214
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 312835
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 96215
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 314215
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 96216
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 312836
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 96217
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 311277
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 96218
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099563
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96219
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 904932
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 96220
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 313758
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0