CMS Formulary

Displaying 97621-97630 of 1611142 results.
ID: 97621
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486841
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97622
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 798300
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97623
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 830253
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97624
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 830245
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97625
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 836636
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97626
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 836634
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97627
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597099
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 365
ID: 97628
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597103
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 365
ID: 97629
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1292443
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97630
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 804186
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0