CMS Formulary

Displaying 97371-97380 of 1611142 results.
ID: 97371
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 197682
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97372
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 866910
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97373
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 308867
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97374
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1092357
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97375
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665473
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 97376
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1798370
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 97377
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1798375
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 97378
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 200132
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 97379
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 199149
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 97380
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 199150
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30