CMS Formulary

Displaying 6351-6360 of 1611142 results.
ID: 6351
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921589
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 6352
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862590
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 6353
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1666542
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6354
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 831246
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6355
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 849515
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6356
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 833008
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6357
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 883826
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 6358
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197943
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6359
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197944
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6360
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659929
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0