CMS Formulary

Displaying 64901-64910 of 1611142 results.
ID: 64901
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049121
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 64902
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1855072
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 64903
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986331
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 64904
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1918230
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 64905
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054269
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64906
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 432400
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 64907
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1940654
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 64908
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1944382
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 64909
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1944376
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 64910
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921081
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30