CMS Formulary

Displaying 6361-6370 of 1611142 results.
ID: 6361
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102705
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6362
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058906
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6363
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1872458
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 6364
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049133
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 6365
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049121
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 6366
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1855072
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 6367
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986331
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 6368
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1918230
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 6369
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054269
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6370
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 432400
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30