CMS Formulary

Displaying 57981-57990 of 1611142 results.
ID: 57981
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 198188
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57982
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 313134
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57983
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 562508
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57984
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 617430
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57985
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 199884
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57986
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 311296
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57987
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 200285
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57988
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 349353
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57989
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 636042
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 57990
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 636045
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0