CMS Formulary

Displaying 56741-56750 of 1611142 results.
ID: 56741
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197817
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 56742
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197818
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 56743
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197889
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56744
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 855172
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56745
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 242679
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56746
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 309313
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 600
Qty Limit Days: 30
ID: 56747
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 351285
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56748
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123194
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 56749
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 313565
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56750
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 313564
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0