CMS Formulary

Displaying 57011-57020 of 1611142 results.
ID: 57011
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122526
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57012
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2380551
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57013
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2374566
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57014
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790146
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57015
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197839
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57016
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 313447
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57017
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 835593
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57018
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 835564
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57019
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 835568
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57020
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197739
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0