CMS Formulary

Displaying 6191-6200 of 1611142 results.
ID: 6191
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 577317
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6192
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 836395
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 6193
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 833234
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6194
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 905158
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6195
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 199376
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6196
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 199381
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6197
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 898490
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6198
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 686429
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6199
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988308
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6200
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988311
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0