CMS Formulary

Displaying 63901-63910 of 1611142 results.
ID: 63901
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1662285
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63902
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 984082
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63903
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551923
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 63904
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601373
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 63905
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1654079
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63906
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 853354
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63907
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 853356
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63908
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 848164
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63909
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653144
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63910
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482814
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0