CMS Formulary

Displaying 64101-64110 of 1611142 results.
ID: 64101
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 903891
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64102
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 903884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64103
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 242446
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64104
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 857700
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 64105
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 213291
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64106
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111339
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64107
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 860805
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64108
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111343
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64109
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 284008
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 64110
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 313919
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28