CMS Formulary

Displaying 63201-63210 of 1611142 results.
ID: 63201
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1737578
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63202
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659283
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63203
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659287
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63204
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 242800
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63205
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721315
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63206
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721314
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63207
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1361574
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63208
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 616539
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 63209
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 616541
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 63210
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 317094
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0