CMS Formulary

Displaying 64891-64900 of 1611142 results.
ID: 64891
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 849515
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64892
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 833008
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64893
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 883826
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 64894
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 197943
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64895
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 197944
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64896
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659929
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64897
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102705
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64898
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058906
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64899
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1872458
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 64900
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049133
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30