CMS Formulary

Displaying 62301-62310 of 1611142 results.
ID: 62301
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 859835
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62302
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 905273
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62303
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099687
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62304
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 312036
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62305
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 856940
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2700
Qty Limit Days: 30
ID: 62306
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 834137
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62307
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 810002
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 62308
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 809990
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 62309
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 809994
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 62310
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 809998
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30