CMS Formulary

Displaying 64421-64430 of 1611142 results.
ID: 64421
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110774
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 64422
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110777
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 64423
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110780
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 64424
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110783
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 64425
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110786
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 64426
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2183131
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 64427
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 866907
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64428
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000133
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64429
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801519
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 64430
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 539789
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30