CMS Formulary

Displaying 57711-57720 of 1611142 results.
ID: 57711
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 831325
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57712
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 831349
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57713
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801298
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57714
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801294
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57715
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1044591
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 57716
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 311192
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57717
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 311197
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57718
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 311196
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57719
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 897584
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57720
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 897590
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0