CMS Formulary

Displaying 6341-6350 of 1611142 results.
ID: 6341
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1798375
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 6342
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 200132
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 6343
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 199149
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 6344
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 199150
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 6345
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 311915
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6346
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1725064
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 6347
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001439
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 6348
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437713
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6349
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1918242
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 6350
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862595
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30