CMS Formulary

Displaying 63361-63370 of 1611142 results.
ID: 63361
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 857169
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63362
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 857183
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63363
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 857187
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63364
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 197732
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63365
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 312750
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63366
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 312748
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63367
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 312079
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 63368
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 208185
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63369
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 577127
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 63370
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 403908
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0