CMS Formulary

Displaying 55291-55300 of 1611142 results.
ID: 55291
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2370174
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 55292
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2170613
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 30
ID: 55293
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2395785
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 55294
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2370170
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 55295
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047247
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55296
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2256947
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 30
ID: 55297
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946836
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 55298
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2256943
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 30
ID: 55299
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2205474
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55300
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946840
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28