CMS Formulary

Displaying 55471-55480 of 1611142 results.
ID: 55471
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797907
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 30
ID: 55472
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197730
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55473
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197731
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55474
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 864761
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 55475
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 864769
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 600
Qty Limit Days: 30
ID: 55476
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 315187
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55477
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 856724
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55478
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 856733
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55479
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 309371
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55480
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197577
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0