CMS Formulary

Displaying 62121-62130 of 1611142 results.
ID: 62121
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 884619
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 62122
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2121061
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28
ID: 62123
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1656356
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62124
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1859501
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 62125
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1919094
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 224
Qty Limit Days: 28
ID: 62126
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2169314
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 62127
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2169322
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 62128
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2362240
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 62129
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2169320
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 62130
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2362244
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30