CMS Formulary

Displaying 62461-62470 of 1611142 results.
ID: 62461
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 801417
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62462
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 204520
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62463
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799890
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62464
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 800928
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62465
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 800812
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62466
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1189640
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62467
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 800933
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62468
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001321
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 62469
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091843
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 62470
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 402091
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30