CMS Formulary

Displaying 57581-57590 of 1611142 results.
ID: 57581
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 312301
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57582
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197684
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57583
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197685
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57584
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 859186
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57585
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197625
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57586
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197626
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57587
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197627
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57588
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197628
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57589
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 199390
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57590
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197553
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0