CMS Formulary

Displaying 6411-6420 of 1611142 results.
ID: 6411
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2265701
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 6412
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283505
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 6413
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283515
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 6414
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283518
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 6415
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283509
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 6416
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283513
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 6417
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283538
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6418
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283536
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6419
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283540
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6420
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 311944
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0