CMS Formulary

Displaying 61-70 of 1611142 results.
ID: 61
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547118
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 62
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235595
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235591
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 668606
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 65
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 861821
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 66
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 861771
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 67
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729311
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 68
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055766
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 69
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1734642
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 70
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988671
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28