CMS Formulary

Displaying 96771-96780 of 1611142 results.
ID: 96771
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371050
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 96772
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371054
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 96773
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371058
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 96774
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371062
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 96775
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371066
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 96776
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482513
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 96777
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482517
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 96778
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482523
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 96779
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482527
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 96780
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235249
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30