CMS Formulary

Displaying 63721-63730 of 1611142 results.
ID: 63721
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 310285
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63722
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 198359
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63723
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 389242
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63724
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 204119
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63725
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2287905
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 63726
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2056700
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 63727
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1358775
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63728
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 751884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63729
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1011081
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63730
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1112687
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84