CMS Formulary

Displaying 97541-97550 of 1611142 results.
ID: 97541
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046597
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 228
Qty Limit Days: 14
ID: 97542
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989117
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 97543
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178792
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 97544
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 644304
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97545
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 861659
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97546
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 861661
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97547
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 861663
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97548
Formulary ID: 00021037
Formulary Version: 14
Contract Year: 2021
RXCUI: 545278
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97549
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551300
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 97550
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551306
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28