CMS Formulary

Displaying 58181-58190 of 1611142 results.
ID: 58181
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1543553
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58182
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1422081
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58183
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1427300
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58184
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 748800
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58185
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1599949
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 58186
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 848180
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58187
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123072
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 17
Qty Limit Days: 30
ID: 58188
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 314076
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58189
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 314077
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58190
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 205326
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0