CMS Formulary

Displaying 55461-55470 of 1611142 results.
ID: 55461
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 900575
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55462
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 977427
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55463
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 977434
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55464
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 977438
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55465
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 892625
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 55466
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 311355
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55467
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197893
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55468
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 313932
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55469
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 309843
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 55470
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190568
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0