CMS Formulary

Displaying 96441-96450 of 1611142 results.
ID: 96441
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 616698
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 96442
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 616705
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 96443
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 312635
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96444
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 198365
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96445
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 995666
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96446
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 198145
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96447
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 313215
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96448
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 313217
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96449
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 313219
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96450
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 260376
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0