CMS Formulary

Displaying 55661-55670 of 1611142 results.
ID: 55661
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 831102
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55662
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 831054
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55663
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197724
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55664
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197381
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55665
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197379
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55666
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 904458
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55667
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197380
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55668
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 198045
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55669
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 317136
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55670
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 198046
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0