CMS Formulary

Displaying 53001-53010 of 1611142 results.
ID: 53001
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 751885
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53002
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 753481
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53003
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 762333
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53004
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 751890
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53005
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1358780
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53006
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1358765
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53007
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359030
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53008
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359025
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53009
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359135
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53010
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1095362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0