CMS Formulary

Displaying 62781-62790 of 1611142 results.
ID: 62781
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 261178
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 62782
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 198300
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62783
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 106303
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62784
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 313450
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62785
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 313451
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62786
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 308508
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62787
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 310149
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 4
ID: 62788
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000673
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62789
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 284254
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62790
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 197900
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30