CMS Formulary

Displaying 63781-63790 of 1611142 results.
ID: 63781
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921598
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63782
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 828348
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63783
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369831
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30
ID: 63784
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870950
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 63785
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870956
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 63786
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870952
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 63787
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870960
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 63788
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870968
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 28
ID: 63789
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1304985
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 63790
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1811182
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30