CMS Formulary

Displaying 61581-61590 of 1611142 results.
ID: 61581
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 199889
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 61582
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 311486
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 61583
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 904396
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 61584
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 199672
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 61585
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 252559
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 61586
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 239238
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 61587
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 602393
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 61588
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 432402
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 61589
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 477560
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 61590
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 477562
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0