CMS Formulary

Displaying 62431-62440 of 1611142 results.
ID: 62431
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 197816
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62432
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 197815
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62433
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1001004
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62434
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 351264
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 62435
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 904605
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62436
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 904571
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62437
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 904583
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62438
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 904593
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62439
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 848951
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62440
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 834346
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0