CMS Formulary

Displaying 56931-56940 of 1611142 results.
ID: 56931
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 309333
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 56932
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 855168
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56933
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 198245
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56934
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597076
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 56935
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 992441
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56936
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 992454
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56937
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006688
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56938
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197785
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56939
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 197803
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56940
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 798133
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0