CMS Formulary

Displaying 64291-64300 of 1611142 results.
ID: 64291
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 825333
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64292
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 825325
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64293
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 825334
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64294
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 212118
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64295
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 542370
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64296
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988768
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 64297
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921228
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 64298
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988772
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 64299
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988786
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64300
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1723763
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28