CMS Formulary

Displaying 97321-97330 of 1611142 results.
ID: 97321
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2265729
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 97322
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2265732
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 97323
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2265735
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 97324
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809643
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97325
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809499
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97326
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1495070
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28
ID: 97327
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 199888
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97328
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 151226
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97329
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 199889
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97330
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 311486
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0