CMS Formulary

Displaying 56401-56410 of 1611142 results.
ID: 56401
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 403810
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 56402
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 403811
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 56403
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806195
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 56404
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806179
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 56405
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806183
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 56406
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 308191
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56407
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 199119
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56408
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 864110
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56409
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 854302
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56410
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1793916
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28