CMS Formulary

Displaying 58141-58150 of 1611142 results.
ID: 58141
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197453
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58142
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 309110
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58143
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 309113
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58144
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 200345
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 58145
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197903
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58146
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197904
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58147
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197905
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58148
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 311353
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58149
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 311354
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58150
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197884
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0