CMS Formulary

Displaying 62941-62950 of 1611142 results.
ID: 62941
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 617423
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62942
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 617993
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62943
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 314227
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 62944
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 142046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62945
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 238004
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 62946
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 313921
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 62947
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 238003
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 62948
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 403923
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 62949
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 241946
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 62950
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 198322
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0