CMS Formulary

Displaying 57811-57820 of 1611142 results.
ID: 57811
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 312447
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57812
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 597823
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57813
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1726214
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57814
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721458
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57815
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721460
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57816
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1726204
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57817
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 312821
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57818
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 204509
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57819
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 312069
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57820
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 312070
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0