CMS Formulary

Displaying 97781-97790 of 1611142 results.
ID: 97781
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2057205
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97782
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2057216
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97783
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2057212
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97784
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2057219
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97785
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099952
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 97786
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105860
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 97787
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 2469340
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97788
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 637188
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 336
Qty Limit Days: 365
ID: 97789
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 795735
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 336
Qty Limit Days: 365
ID: 97790
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 637190
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 336
Qty Limit Days: 365