CMS Formulary

Displaying 62711-62720 of 1611142 results.
ID: 62711
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 860918
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62712
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 859841
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62713
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 313159
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 62714
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 197516
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62715
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 197517
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62716
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 996740
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 62717
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 311369
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 62718
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482908
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62719
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806187
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 62720
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806189
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30