CMS Formulary

Displaying 57311-57320 of 1611142 results.
ID: 57311
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373337
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57312
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 312084
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57313
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 198051
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57314
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 312077
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 57315
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 313412
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57316
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 313413
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57317
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 314286
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 57318
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 313776
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 57319
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 313777
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 57320
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 313778
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30