CMS Formulary

Displaying 55971-55980 of 1611142 results.
ID: 55971
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1942489
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 55972
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047639
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 55973
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053927
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 55974
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721571
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 55975
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721583
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 55976
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989109
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 55977
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2205634
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 55978
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2387331
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 28
ID: 55979
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486981
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 55980
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486977
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30