CMS Formulary

Displaying 56991-57000 of 1611142 results.
ID: 56991
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 577324
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56992
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 727316
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 56993
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870207
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 56994
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 1374574
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 224
Qty Limit Days: 28
ID: 56995
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2003255
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 56996
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 2198370
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 56997
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 865208
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 56998
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 865212
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 56999
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 865216
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 57000
Formulary ID: 00021020
Formulary Version: 14
Contract Year: 2021
RXCUI: 723827
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0