CMS Formulary

Displaying 55671-55680 of 1611142 results.
ID: 55671
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 198047
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55672
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 312059
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55673
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 866018
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55674
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 603103
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55675
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 106346
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 220
Qty Limit Days: 30
ID: 55676
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098649
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55677
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098670
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55678
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098674
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55679
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923422
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55680
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923426
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0