CMS Formulary

Displaying 55361-55370 of 1611142 results.
ID: 55361
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 836636
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55362
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 836634
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55363
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597099
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 365
ID: 55364
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597103
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 365
ID: 55365
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1292443
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55366
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 804186
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55367
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1292459
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 365
ID: 55368
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658106
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55369
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658102
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55370
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 798451
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0