CMS Formulary

Displaying 97611-97620 of 1611142 results.
ID: 97611
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235591
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97612
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 668606
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97613
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 861821
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 97614
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 861771
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 97615
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729311
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 97616
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055766
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97617
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1734642
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 97618
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988671
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 97619
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988675
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 97620
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1924315
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0