CMS Formulary

Displaying 62691-62700 of 1611142 results.
ID: 62691
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 755497
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62692
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 992765
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62693
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 630208
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 62694
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 245314
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 62695
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 485968
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 62696
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 991061
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62697
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 857683
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62698
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000913
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62699
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 198202
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62700
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 857677
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0