CMS Formulary

Displaying 63061-63070 of 1611142 results.
ID: 63061
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 284496
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63062
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 855926
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 63063
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 855906
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 63064
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 855664
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 63065
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 995281
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63066
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1095227
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63067
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1304988
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63068
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1661092
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 63069
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 309079
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63070
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1438778
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0