CMS Formulary

Displaying 97141-97150 of 1611142 results.
ID: 97141
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 312122
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 42
Qty Limit Days: 180
ID: 97142
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 200346
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97143
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 308135
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97144
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 309054
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97145
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 848140
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97146
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 848131
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97147
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 848145
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97148
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 848151
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97149
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 848135
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97150
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 854894
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30