CMS Formulary

Displaying 57631-57640 of 1611142 results.
ID: 57631
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091654
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57632
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235150
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57633
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235157
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57634
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 310467
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57635
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 310377
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57636
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 745462
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57637
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 731566
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57638
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 731568
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57639
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 731571
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57640
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049223
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30