CMS Formulary

Displaying 53131-53140 of 1611142 results.
ID: 53131
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 403920
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53132
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 312068
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53133
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 314152
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53134
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 312071
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53135
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 859867
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53136
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 992481
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53137
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 198159
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53138
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191256
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53139
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 992459
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53140
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 311678
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0