CMS Formulary

Displaying 64381-64390 of 1611142 results.
ID: 64381
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 309077
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64382
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 313428
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64383
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 242680
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64384
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 205292
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64385
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 205290
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64386
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 315134
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64387
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 866021
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64388
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992303
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64389
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 427163
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64390
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2399892
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28