CMS Formulary

Displaying 64741-64750 of 1611142 results.
ID: 64741
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649401
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64742
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054979
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 64743
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054983
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 64744
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055016
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 64745
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055014
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 64746
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 197701
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64747
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 310433
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 64748
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 310434
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 64749
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 403966
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64750
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 403967
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0