CMS Formulary

Displaying 56461-56470 of 1611142 results.
ID: 56461
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 855322
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56462
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 855328
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56463
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 855336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56464
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 855342
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56465
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 855348
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56466
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 855300
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56467
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809730
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56468
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809738
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56469
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809667
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56470
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 854228
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30