CMS Formulary

Displaying 63931-63940 of 1611142 results.
ID: 63931
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 798482
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63932
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 798479
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63933
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300378
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63934
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300370
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63935
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 805579
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63936
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 901518
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63937
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 830463
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63938
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601407
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63939
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 809159
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 63940
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 802652
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0