CMS Formulary

Displaying 6391-6400 of 1611142 results.
ID: 6391
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992873
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 6392
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2119706
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 6393
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 349287
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6394
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1927682
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 14
ID: 6395
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 313362
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6396
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 313364
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6397
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 313361
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6398
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197558
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6399
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197557
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6400
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 903843
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0