CMS Formulary

Displaying 63141-63150 of 1611142 results.
ID: 63141
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 897683
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63142
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 314184
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63143
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 310537
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63144
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 897722
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63145
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 197942
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63146
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 197941
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63147
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 861007
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 63148
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 861010
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 63149
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 861004
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 75
Qty Limit Days: 30
ID: 63150
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 861731
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30