CMS Formulary

Displaying 61951-61960 of 1611142 results.
ID: 61951
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 905168
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 61952
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 892589
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 700
Qty Limit Days: 30
ID: 61953
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 894780
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 61954
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 997287
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 61955
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 997296
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 61956
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 310792
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 61957
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 310793
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 61958
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 197624
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 61959
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437968
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 61960
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437969
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0