CMS Formulary

Displaying 6771-6780 of 1611142 results.
ID: 6771
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049858
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 6772
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049862
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 6773
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1855527
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6774
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921240
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6775
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921245
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6776
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1726846
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6777
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 847745
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 6778
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1872980
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 6779
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747577
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 6780
Formulary ID: 00021002
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747579
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30