CMS Formulary

Displaying 96481-96490 of 1611142 results.
ID: 96481
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 311727
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96482
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 317128
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96483
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 309337
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96484
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 197388
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96485
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 197980
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96486
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 544455
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96487
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 617322
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96488
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 863599
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96489
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 995241
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96490
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 309686
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0