CMS Formulary

Displaying 55631-55640 of 1611142 results.
ID: 55631
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1873995
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 63
Qty Limit Days: 28
ID: 55632
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1421456
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55633
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923054
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 49
Qty Limit Days: 28
ID: 55634
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801840
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 55635
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923056
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 70
Qty Limit Days: 28
ID: 55636
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923058
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 28
ID: 55637
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2002719
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 55638
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058981
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 55639
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123314
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55640
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2121096
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28