CMS Formulary

Displaying 97551-97560 of 1611142 results.
ID: 97551
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058877
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 97552
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1745108
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97553
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2395779
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 97554
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058887
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 97555
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2370174
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 97556
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2170613
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 30
ID: 97557
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2395785
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 97558
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2370170
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 97559
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047247
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97560
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2256947
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 30