CMS Formulary

Displaying 64111-64120 of 1611142 results.
ID: 64111
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797865
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 34
Qty Limit Days: 28
ID: 64112
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797867
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 25
ID: 64113
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 860107
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 25
ID: 64114
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 904481
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64115
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 617312
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64116
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 617310
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64117
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 617311
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64118
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 310818
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64119
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 259255
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64120
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 905028
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28