CMS Formulary

Displaying 56661-56670 of 1611142 results.
ID: 56661
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 313888
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56662
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 309042
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56663
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 309683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56664
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1012021
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56665
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 849506
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56666
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797863
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 50
Qty Limit Days: 25
ID: 56667
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 213262
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56668
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 545259
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56669
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099503
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56670
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 850309
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0