CMS Formulary

Displaying 97001-97010 of 1611142 results.
ID: 97001
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1442143
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 97002
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729053
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 97003
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729057
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 97004
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729061
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 97005
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729065
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 97006
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729013
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 97007
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729029
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 97008
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729033
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 97009
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729047
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 97010
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729076
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0