CMS Formulary

Displaying 97921-97930 of 1611142 results.
ID: 97921
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 866094
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97922
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 866083
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97923
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 211817
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97924
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801283
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97925
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 857461
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97926
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 978006
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97927
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 834022
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 30
ID: 97928
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 833217
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97929
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 831103
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 97930
Formulary ID: 00021038
Formulary Version: 14
Contract Year: 2021
RXCUI: 831102
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0