CMS Formulary

Displaying 55151-55160 of 1611142 results.
ID: 55151
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1940654
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 55152
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1944382
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 55153
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1944376
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 55154
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921081
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 55155
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1866047
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55156
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099026
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55157
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099269
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55158
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006065
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55159
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1020155
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 55160
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1720616
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0