CMS Formulary

Displaying 61851-61860 of 1611142 results.
ID: 61851
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235591
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 61852
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 668606
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 61853
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 861821
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 61854
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 861771
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 61855
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729311
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 61856
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055766
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 61857
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1734642
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 61858
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988671
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 61859
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988675
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 61860
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1924315
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0