CMS Formulary

Displaying 62831-62840 of 1611142 results.
ID: 62831
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 197365
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62832
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 197366
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62833
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 197363
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62834
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 197364
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62835
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 197383
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62836
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 197382
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62837
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 805515
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62838
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 603378
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62839
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190225
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 30
ID: 62840
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 580261
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30