CMS Formulary

Displaying 57271-57280 of 1611142 results.
ID: 57271
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010878
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57272
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085741
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57273
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191302
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57274
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 310152
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 57275
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2180999
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57276
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1716268
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57277
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921598
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57278
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 828348
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57279
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369831
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30
ID: 57280
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870950
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30