CMS Formulary

Displaying 6721-6730 of 1611142 results.
ID: 6721
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243010
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 6722
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243014
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 6723
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601394
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 6724
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601386
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 6725
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601390
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 6726
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1987734
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 6727
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058922
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 6728
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 2103175
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 6729
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 2103179
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 6730
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 810075
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0