CMS Formulary

Displaying 56791-56800 of 1611142 results.
ID: 56791
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1363410
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 56792
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364581
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 56793
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790175
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 56794
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790167
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 56795
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790171
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 56796
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1928941
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 56797
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197703
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56798
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300783
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56799
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 831261
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56800
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 829500
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0