CMS Formulary

Displaying 62281-62290 of 1611142 results.
ID: 62281
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 308865
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 62282
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860154
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 62283
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860151
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 62284
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860127
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 62285
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 856448
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62286
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 856457
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62287
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 856519
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62288
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 856578
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62289
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 856556
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62290
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 856605
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0