CMS Formulary

Displaying 55841-55850 of 1611142 results.
ID: 55841
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2206092
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 55842
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2206099
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 55843
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049380
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 55844
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986354
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 55845
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986356
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 55846
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2205454
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 55847
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653198
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 55848
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 977842
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 55849
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 977840
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 55850
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 897126
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30