CMS Formulary

Displaying 63741-63750 of 1611142 results.
ID: 63741
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 749848
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63742
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 753544
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63743
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 750244
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63744
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806177
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 63745
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806185
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 63746
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2468058
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63747
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2471314
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63748
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 748962
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63749
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 831533
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63750
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 312138
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0