CMS Formulary

Displaying 55451-55460 of 1611142 results.
ID: 55451
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 997296
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 55452
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 310792
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55453
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 310793
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55454
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197624
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55455
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437968
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55456
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437969
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55457
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 897657
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 55458
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049604
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1300
Qty Limit Days: 30
ID: 55459
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1874559
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 55460
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1874553
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30