CMS Formulary

Displaying 96651-96660 of 1611142 results.
ID: 96651
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 312847
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96652
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 205284
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96653
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 205285
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96654
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 643019
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 96655
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 643022
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 96656
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 866482
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96657
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 866479
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96658
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 349401
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96659
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 349405
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96660
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 205322
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30