CMS Formulary

Displaying 62231-62240 of 1611142 results.
ID: 62231
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 995218
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62232
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 866090
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62233
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 643066
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62234
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1652084
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62235
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006801
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 62236
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 996921
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 62237
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 721773
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 62238
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 476179
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 62239
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 476177
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 62240
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 199703
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0