CMS Formulary

Displaying 96511-96520 of 1611142 results.
ID: 96511
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 993687
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96512
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 993691
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96513
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 903887
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96514
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 903891
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96515
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 903884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96516
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 242446
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96517
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 857700
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 96518
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 213291
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96519
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111339
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96520
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 860805
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0