CMS Formulary

Displaying 63771-63780 of 1611142 results.
ID: 63771
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2465556
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63772
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 905394
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63773
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 404539
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63774
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1543069
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 63775
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010878
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63776
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085741
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63777
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191302
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63778
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 310152
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 63779
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2180999
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63780
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1716268
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0