CMS Formulary

Displaying 63571-63580 of 1611142 results.
ID: 63571
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1242815
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 56
ID: 63572
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 616749
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63573
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 728231
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63574
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1657212
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63575
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1735537
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63576
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 992403
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63577
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1735496
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63578
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1147228
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 63579
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2197873
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 63580
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2197877
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30