CMS Formulary

Displaying 96861-96870 of 1611142 results.
ID: 96861
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 197745
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96862
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 197746
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96863
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 198358
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96864
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099569
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96865
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244214
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96866
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 197312
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 96867
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 485496
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 96868
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 348719
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 96869
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110774
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 96870
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110777
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28