CMS Formulary

Displaying 55051-55060 of 1611142 results.
ID: 55051
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 831359
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55052
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 801957
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55053
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 801961
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55054
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 801966
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55055
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 245723
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55056
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 830861
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55057
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 830845
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55058
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 830837
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55059
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 830801
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55060
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 352257
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30