CMS Formulary

Displaying 57341-57350 of 1611142 results.
ID: 57341
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659149
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57342
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1734932
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57343
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665517
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57344
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1668238
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57345
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1722939
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57346
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 861360
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57347
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1734683
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57348
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1492746
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57349
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 727542
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57350
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 727545
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0