CMS Formulary

Displaying 57251-57260 of 1611142 results.
ID: 57251
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 403884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57252
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 310599
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57253
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 856535
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57254
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 856569
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57255
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 856460
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57256
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 856481
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57257
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 860654
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57258
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 199450
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 57259
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 246172
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 57260
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1606337
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30