CMS Formulary

Displaying 56641-56650 of 1611142 results.
ID: 56641
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197942
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56642
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197941
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56643
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 861007
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 56644
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 861010
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 56645
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 861004
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 75
Qty Limit Days: 30
ID: 56646
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 861731
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 56647
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 562524
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56648
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1652673
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56649
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650142
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56650
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 353538
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0