CMS Formulary

Displaying 61351-61360 of 1611142 results.
ID: 61351
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 898715
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 61352
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 282755
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 61353
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 205304
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 61354
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 205305
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 61355
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 409823
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 61356
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 892582
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 61357
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 892672
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 61358
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923822
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 61359
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923828
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 61360
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923826
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0