CMS Formulary

Displaying 64361-64370 of 1611142 results.
ID: 64361
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 198252
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64362
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649593
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 64363
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1546189
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 64364
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2261794
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 64365
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040058
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 64366
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 858804
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64367
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 794641
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 64368
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 617768
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 64369
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790892
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 64370
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790886
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30