CMS Formulary

Displaying 55001-55010 of 1611142 results.
ID: 55001
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 151029
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55002
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 311265
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55003
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 311264
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55004
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 897649
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55005
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 349594
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 55006
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 349595
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 55007
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 608143
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 55008
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 608139
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 55009
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 897659
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55010
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 897640
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0