CMS Formulary

Displaying 57361-57370 of 1611142 results.
ID: 57361
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123191
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 57362
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 727537
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57363
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648162
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57364
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648160
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57365
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2048718
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 57366
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2048722
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 57367
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1991509
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57368
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1865962
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57369
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197699
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57370
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197700
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0