CMS Formulary

Displaying 63881-63890 of 1611142 results.
ID: 63881
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 310436
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 63882
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 310437
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 63883
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 579148
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 63884
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 104894
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63885
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 861132
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 63886
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 310352
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63887
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 310353
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63888
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 200257
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 63889
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 200256
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 63890
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 200258
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30