CMS Formulary

Displaying 63211-63220 of 1611142 results.
ID: 63211
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 349435
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63212
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 349434
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63213
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 310289
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63214
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 855858
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 63215
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 313306
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63216
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 348472
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63217
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 282401
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63218
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 198427
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63219
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 198428
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63220
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 198429
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0