CMS Formulary

Displaying 6491-6500 of 1611142 results.
ID: 6491
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 105553
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6492
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 105590
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6493
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364498
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 45
Qty Limit Days: 30
ID: 6494
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364490
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 6495
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364494
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 6496
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648772
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 6497
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046597
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 228
Qty Limit Days: 14
ID: 6498
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989117
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 6499
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178792
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 6500
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 644304
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0