CMS Formulary

Displaying 55911-55920 of 1611142 results.
ID: 55911
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197979
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55912
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197978
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55913
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1246306
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 55914
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1246290
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 55915
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1666334
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55916
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1116639
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55917
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1872261
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55918
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055008
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55919
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 991233
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55920
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 308047
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30