CMS Formulary

Displaying 56871-56880 of 1611142 results.
ID: 56871
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307056
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 56872
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010604
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 56873
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 198182
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56874
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 351223
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 56875
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 198070
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56876
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 401938
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 56877
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 751566
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56878
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 751568
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56879
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 751570
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56880
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 897044
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0