CMS Formulary

Displaying 61541-61550 of 1611142 results.
ID: 61541
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 748798
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 61542
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989507
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 61543
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876920
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 61544
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876924
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 61545
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876916
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 61546
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111642
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 61547
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487363
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 61548
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 308725
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 420
Qty Limit Days: 30
ID: 61549
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 855657
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 61550
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812011
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0