CMS Formulary

Displaying 57781-57790 of 1611142 results.
ID: 57781
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054159
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57782
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1604350
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57783
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1792393
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57784
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1604395
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57785
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1604352
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57786
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 825335
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57787
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 825333
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57788
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 825325
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57789
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 825334
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57790
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 212118
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0