CMS Formulary

Displaying 97181-97190 of 1611142 results.
ID: 97181
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 205316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97182
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 205315
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97183
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 313583
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 97184
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 313585
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 97185
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 992438
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97186
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 992447
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97187
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 310672
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97188
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 314035
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97189
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 197754
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97190
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 686924
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0