CMS Formulary

Displaying 63751-63760 of 1611142 results.
ID: 63751
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 312839
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 63752
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 312837
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 63753
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091341
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 63754
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359124
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63755
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 403884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63756
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 310599
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63757
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 856535
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63758
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 856569
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63759
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 856460
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63760
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 856481
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0