CMS Formulary

Displaying 57551-57560 of 1611142 results.
ID: 57551
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1048445
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57552
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 855626
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 57553
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 855194
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57554
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607617
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 57555
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 311345
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57556
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 198200
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57557
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 351256
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57558
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 351257
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57559
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 310261
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57560
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 308459
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0