CMS Formulary

Displaying 64051-64060 of 1611142 results.
ID: 64051
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 313142
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64052
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 312347
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64053
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1048450
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64054
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1020065
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 64055
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1048445
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64056
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 855626
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 64057
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 855194
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64058
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607617
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 64059
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 311345
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64060
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 198200
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0