CMS Formulary

Displaying 62681-62690 of 1611142 results.
ID: 62681
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2052704
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62682
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105817
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 62683
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300797
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62684
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300803
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62685
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 967388
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62686
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 307730
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62687
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 106302
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62688
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 884308
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 62689
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 106387
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62690
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 308714
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30