CMS Formulary

Displaying 58631-58640 of 1611142 results.
ID: 58631
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 404459
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58632
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1549456
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58633
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1549454
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58634
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 205562
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58635
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 763489
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58636
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 996559
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58637
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 762833
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58638
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 762836
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58639
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 762839
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58640
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 762843
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0