CMS Formulary

Displaying 63341-63350 of 1611142 results.
ID: 63341
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 967012
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63342
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 198332
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63343
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 197702
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63344
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736047
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 63345
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736050
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 63346
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736053
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 63347
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1736044
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 63348
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 312845
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63349
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 312846
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63350
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 283858
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0