CMS Formulary

Displaying 61241-61250 of 1611142 results.
ID: 61241
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 636042
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 61242
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 636045
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 61243
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 251872
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 61244
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 314200
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 61245
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 349483
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 61246
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 349199
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 61247
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 349200
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 61248
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 200224
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 61249
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 898350
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 61250
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 898353
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0