CMS Formulary

Displaying 53241-53250 of 1611142 results.
ID: 53241
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 996615
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 53242
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 996594
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 53243
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 996603
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 53244
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 996609
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 53245
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1540356
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53246
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 992475
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53247
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 995258
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53248
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1297753
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53249
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1297757
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53250
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049621
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30