CMS Formulary

Displaying 64431-64440 of 1611142 results.
ID: 64431
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 856666
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 64432
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 979115
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 64433
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244062
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 64434
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244064
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 11
Qty Limit Days: 28
ID: 64435
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1596778
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64436
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1673274
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 64437
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1673278
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 64438
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1673280
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 64439
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1925264
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 56
ID: 64440
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049343
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 365