CMS Formulary

Displaying 6271-6280 of 1611142 results.
ID: 6271
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 831359
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6272
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 801957
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6273
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 801961
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6274
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 801966
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6275
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 245723
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6276
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 830861
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6277
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 830845
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6278
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 830837
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6279
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 830801
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6280
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 352257
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30