CMS Formulary

Displaying 97211-97220 of 1611142 results.
ID: 97211
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 836395
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 97212
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 833234
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97213
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 905158
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97214
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 199376
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97215
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 199381
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97216
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 898490
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97217
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 686429
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97218
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 284201
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 30
ID: 97219
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 351134
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 30
ID: 97220
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 314142
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30