CMS Formulary

Displaying 61311-61320 of 1611142 results.
ID: 61311
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 388311
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 61312
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 200133
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 61313
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 200131
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 61314
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 861237
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 61315
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 861221
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 61316
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 861223
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 61317
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 861225
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 61318
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 861227
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 61319
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 861232
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 61320
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1367436
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28