CMS Formulary

Displaying 58851-58860 of 1611142 results.
ID: 58851
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310147
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 58852
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364114
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 58853
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364118
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 58854
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364122
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 58855
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653243
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58856
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1599797
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58857
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603361
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58858
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603365
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58859
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603369
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58860
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1656346
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0