CMS Formulary

Displaying 55581-55590 of 1611142 results.
ID: 55581
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 727705
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55582
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1655728
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55583
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 825170
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55584
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801278
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55585
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 847741
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 55586
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 835892
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55587
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2056897
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55588
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 746609
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 55589
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 845518
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 55590
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 845512
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28