CMS Formulary

Displaying 62501-62510 of 1611142 results.
ID: 62501
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1090639
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62502
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 800438
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62503
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 800444
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62504
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 801012
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62505
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 801000
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62506
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 801021
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62507
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 801031
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62508
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 866924
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62509
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 197465
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 62510
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 197466
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30