CMS Formulary

Displaying 6561-6570 of 1611142 results.
ID: 6561
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 665040
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 6562
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 744846
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6563
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 665036
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 6564
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547114
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 6565
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547118
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 6566
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235595
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6567
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235591
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6568
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 668606
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6569
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 861821
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 6570
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 861771
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30