CMS Formulary

Displaying 6261-6270 of 1611142 results.
ID: 6261
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876916
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 6262
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111642
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 6263
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487363
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 6264
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 308725
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 420
Qty Limit Days: 30
ID: 6265
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 855657
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 6266
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812011
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6267
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812013
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6268
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 562806
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 6269
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 825130
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6270
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 861668
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28