CMS Formulary

Displaying 63641-63650 of 1611142 results.
ID: 63641
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739782
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 63642
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 795085
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63643
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 849599
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63644
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739770
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 63645
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251914
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 63646
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 722256
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 63647
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251918
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 63648
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 724142
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 63649
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 724156
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 63650
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251922
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30