CMS Formulary

Displaying 62411-62420 of 1611142 results.
ID: 62411
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 198228
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62412
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 852913
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62413
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 993536
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62414
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 852877
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62415
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 197979
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62416
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 197978
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62417
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1246306
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 62418
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1246290
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 62419
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1666334
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62420
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1116639
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0