CMS Formulary

Displaying 57001-57010 of 1611142 results.
ID: 57001
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 729201
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57002
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 729203
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57003
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796079
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57004
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796083
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57005
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433879
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57006
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1546894
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57007
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1857913
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57008
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1857917
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57009
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1857925
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57010
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989506
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0