CMS Formulary

Displaying 62051-62060 of 1611142 results.
ID: 62051
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148506
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 62052
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148502
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 62053
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2168540
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 62054
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 207088
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62055
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049858
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 62056
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049862
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 62057
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1855527
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62058
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921240
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62059
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921245
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62060
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1726846
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0