CMS Formulary

Displaying 96661-96670 of 1611142 results.
ID: 96661
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 205323
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 96662
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 403853
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96663
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 403854
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96664
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 403855
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96665
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 859981
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 96666
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 859975
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 96667
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 283316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96668
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 283317
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96669
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 477130
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96670
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 849389
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0