CMS Formulary

Displaying 64401-64410 of 1611142 results.
ID: 64401
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 995624
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64402
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2266506
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 64403
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 857336
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64404
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 857321
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64405
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 857328
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64406
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 857340
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64407
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 259081
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 64408
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 835603
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 64409
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 283536
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64410
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 199387
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30