CMS Formulary

Displaying 96321-96330 of 1611142 results.
ID: 96321
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2118741
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96322
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000019
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 96323
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1994362
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 96324
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1442992
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 96325
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000023
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 96326
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000027
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 96327
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000031
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 96328
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300386
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96329
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 829989
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96330
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 830552
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0