CMS Formulary

Displaying 64931-64940 of 1611142 results.
ID: 64931
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 313362
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64932
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 313364
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64933
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 313361
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64934
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 197558
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64935
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 197557
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64936
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 903843
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64937
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1661799
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 64938
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946589
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 32
Qty Limit Days: 30
ID: 64939
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 1421461
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 64940
Formulary ID: 00021022
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044928
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30