CMS Formulary

Displaying 64711-64720 of 1611142 results.
ID: 64711
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1738495
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64712
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1738503
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64713
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099596
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64714
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 197412
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64715
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 312828
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 64716
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 312829
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 64717
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 312830
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 64718
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 312831
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 64719
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 312832
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 64720
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 314211
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30