CMS Formulary

Displaying 64781-64790 of 1611142 results.
ID: 64781
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 307731
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64782
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 864675
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64783
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 835726
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64784
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 349373
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64785
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 857216
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64786
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 857224
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64787
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 314266
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 64788
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 749784
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64789
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 644088
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 64790
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603861
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84