CMS Formulary

Displaying 55791-55800 of 1611142 results.
ID: 55791
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 351133
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55792
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 313979
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55793
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 834127
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55794
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 141935
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55795
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 849385
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55796
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 861848
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55797
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 859835
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55798
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 905273
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55799
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099687
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55800
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 312036
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0