CMS Formulary

Displaying 56571-56580 of 1611142 results.
ID: 56571
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1539953
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56572
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1539955
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56573
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1605086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56574
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 904419
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 56575
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 866436
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56576
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 855633
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56577
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607784
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56578
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 199245
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 56579
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 199246
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 56580
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 199247
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30