CMS Formulary

Displaying 56541-56550 of 1611142 results.
ID: 56541
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 855189
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56542
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 602964
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 56543
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 402131
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 56544
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 349545
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 56545
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 349490
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 56546
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 349553
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 56547
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 349547
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 56548
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 856373
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56549
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 310288
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56550
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197985
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0