CMS Formulary

Displaying 62991-63000 of 1611142 results.
ID: 62991
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 866103
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 62992
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 672567
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 62993
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 672569
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 62994
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 672571
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 62995
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 993541
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62996
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 993557
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 62997
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 996615
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 62998
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 996594
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 62999
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 996603
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 63000
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 996609
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30