CMS Formulary

Displaying 58441-58450 of 1611142 results.
ID: 58441
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2045958
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 58442
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055286
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58443
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2265701
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 58444
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283505
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 58445
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283515
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 58446
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283518
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 58447
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283509
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 58448
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283513
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 58449
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283538
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58450
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2283536
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0