CMS Formulary

Displaying 64551-64560 of 1611142 results.
ID: 64551
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790317
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64552
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 727714
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64553
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 314230
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64554
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 861646
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 64555
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 861650
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 64556
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 861654
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 64557
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123076
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 36
Qty Limit Days: 30
ID: 64558
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 349591
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 64559
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 349592
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 64560
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 349593
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30