CMS Formulary

Displaying 97501-97510 of 1611142 results.
ID: 97501
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801322
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 7
Qty Limit Days: 28
ID: 97502
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2262446
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 97503
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123034
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97504
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2274390
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 97505
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2282320
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 30
ID: 97506
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1591943
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 97507
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799212
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 97508
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659183
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 97509
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659161
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 97510
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2467571
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30