CMS Formulary

Displaying 57161-57170 of 1611142 results.
ID: 57161
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2359348
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 21
ID: 57162
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2359340
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 21
ID: 57163
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2361300
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 57164
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2361296
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 57165
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2174390
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 57166
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243052
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 57167
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1606866
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 57168
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2257013
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28
ID: 57169
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1606870
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 57170
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053519
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28