CMS Formulary

Displaying 6371-6380 of 1611142 results.
ID: 6371
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1940654
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 6372
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1944382
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 6373
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1944376
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 6374
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921081
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 6375
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1866047
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6376
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099026
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6377
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099269
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6378
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006065
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6379
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1020155
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 6380
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1720616
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0