CMS Formulary

Displaying 64601-64610 of 1611142 results.
ID: 64601
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 311347
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64602
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 311204
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64603
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 898715
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 64604
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 282755
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64605
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 205304
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64606
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 205305
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64607
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 409823
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64608
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 892582
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 64609
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 892672
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 64610
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923822
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0