CMS Formulary

Displaying 6291-6300 of 1611142 results.
ID: 6291
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2265735
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 6292
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809643
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6293
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809499
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6294
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1495070
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28
ID: 6295
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 199888
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6296
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 151226
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6297
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 199889
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6298
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 311486
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6299
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 904396
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 6300
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 199672
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0