CMS Formulary

Displaying 64691-64700 of 1611142 results.
ID: 64691
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123072
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 17
Qty Limit Days: 30
ID: 64692
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 314076
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64693
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 314077
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64694
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 205326
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64695
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 646456
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 64696
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 848768
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 64697
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1738511
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64698
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 205316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64699
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 205315
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64700
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 313583
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30