CMS Formulary

Displaying 63371-63380 of 1611142 results.
ID: 63371
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 198038
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63372
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 198039
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63373
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 198040
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63374
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010600
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 63375
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307056
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 63376
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010604
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 63377
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 198182
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63378
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 351223
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 63379
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 198070
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63380
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 401938
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30