CMS Formulary

Displaying 58551-58560 of 1611142 results.
ID: 58551
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 2205474
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58552
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946840
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 58553
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946844
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 58554
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946848
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 58555
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 207834
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58556
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1718936
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 58557
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1745114
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58558
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 729234
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58559
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 582971
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58560
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 582976
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0