CMS Formulary

Displaying 96431-96440 of 1611142 results.
ID: 96431
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1600710
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96432
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999587
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 96433
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364515
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96434
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2373941
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96435
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049677
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96436
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 762675
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96437
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 259966
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96438
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 197973
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96439
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 401953
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 96440
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 401954
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30