CMS Formulary

Displaying 63161-63170 of 1611142 results.
ID: 63161
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099296
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63162
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 197433
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63163
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 896766
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63164
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 309044
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63165
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 313888
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63166
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 309042
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63167
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 309683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63168
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1012021
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63169
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 849506
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63170
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797863
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 50
Qty Limit Days: 25