CMS Formulary

Displaying 64241-64250 of 1611142 results.
ID: 64241
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 403855
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64242
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 859981
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 64243
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 859975
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 64244
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 849389
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64245
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 313407
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64246
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 313408
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64247
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1536490
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64248
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 310878
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64249
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 311982
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64250
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 104884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0