CMS Formulary

Displaying 55111-55120 of 1611142 results.
ID: 55111
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 310003
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55112
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 310004
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55113
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 310005
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55114
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099681
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55115
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197682
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55116
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 866910
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55117
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 308867
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55118
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1092357
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55119
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665473
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 55120
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1798370
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30