CMS Formulary

Displaying 57461-57470 of 1611142 results.
ID: 57461
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544394
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57462
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544396
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57463
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544398
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57464
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544402
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57465
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659818
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 57466
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659814
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 57467
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658325
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 57468
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658329
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 57469
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658333
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 57470
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658337
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30