CMS Formulary

Displaying 57191-57200 of 1611142 results.
ID: 57191
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 103456
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57192
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 310891
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57193
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 308979
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57194
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197686
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57195
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197303
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57196
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197304
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57197
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197853
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57198
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 858813
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57199
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 858817
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57200
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 858810
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0