CMS Formulary

Displaying 63431-63440 of 1611142 results.
ID: 63431
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 313852
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63432
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 106336
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 63433
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 543460
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63434
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 197574
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 63435
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 309333
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 63436
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 855168
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63437
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 198245
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63438
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597076
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 63439
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 992441
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63440
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 992454
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0