CMS Formulary

Displaying 64921-64930 of 1611142 results.
ID: 64921
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1941476
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64922
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1941473
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64923
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 197698
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64924
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 856783
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64925
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607796
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64926
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607792
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64927
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992873
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 64928
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2119706
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 64929
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 349287
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64930
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1927682
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 14