CMS Formulary

Displaying 56371-56380 of 1611142 results.
ID: 56371
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049635
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 56372
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 198086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56373
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 199167
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56374
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 199164
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56375
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 763181
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56376
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 763179
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56377
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 763185
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56378
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 763183
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56379
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 861424
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56380
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1047040
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0