CMS Formulary

Displaying 63231-63240 of 1611142 results.
ID: 63231
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 996561
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 63232
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 854916
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63233
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 854919
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63234
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 854908
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63235
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 201708
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63236
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 248420
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63237
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 351172
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63238
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 199422
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63239
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 200082
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63240
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 199663
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0