CMS Formulary

Displaying 64631-64640 of 1611142 results.
ID: 64631
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 313570
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 30
ID: 64632
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 313571
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 80
Qty Limit Days: 30
ID: 64633
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 309049
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64634
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 309048
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64635
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 105171
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64636
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 995599
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64637
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 995607
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64638
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 307650
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64639
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 309097
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64640
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 309098
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0