CMS Formulary

Displaying 64451-64460 of 1611142 results.
ID: 64451
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 313222
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64452
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 861743
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64453
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 861748
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64454
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 861753
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64455
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 309076
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64456
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 309078
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64457
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 198352
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64458
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 200031
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64459
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 200033
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64460
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 315223
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30