CMS Formulary

Displaying 64031-64040 of 1611142 results.
ID: 64031
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 259966
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64032
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 197973
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64033
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 401953
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 64034
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 401954
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 64035
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 616698
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 64036
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 616705
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 64037
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 312635
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64038
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 198365
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64039
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 995666
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64040
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 198145
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0