CMS Formulary

Displaying 63281-63290 of 1611142 results.
ID: 63281
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 351108
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 63282
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 349251
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63283
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 905041
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 63284
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 905092
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 63285
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 905100
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 63286
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1095712
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63287
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665515
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63288
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719286
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63289
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 313115
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63290
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 239240
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0