CMS Formulary

Displaying 62611-62620 of 1611142 results.
ID: 62611
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 857005
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 62612
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 856999
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 62613
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 993781
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 62614
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049221
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 62615
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049225
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 62616
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049214
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 62617
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091497
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 62618
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091392
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 62619
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806181
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 62620
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806197
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30