CMS Formulary

Displaying 53141-53150 of 1611142 results.
ID: 53141
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085728
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53142
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191315
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53143
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 628953
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53144
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 381056
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53145
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 206842
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53146
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 198316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53147
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 359296
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53148
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 308212
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53149
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 403810
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 53150
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 403811
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28