CMS Formulary

Displaying 55281-55290 of 1611142 results.
ID: 55281
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 861659
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55282
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 861661
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55283
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 861663
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55284
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 545278
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55285
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551300
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 55286
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551306
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 55287
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058877
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 55288
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1745108
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55289
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2395779
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 55290
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058887
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30