CMS Formulary

Displaying 53251-53260 of 1611142 results.
ID: 53251
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 2101899
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53252
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049683
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 53253
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049686
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 53254
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091150
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 53255
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 899557
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 53256
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 899518
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 53257
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 899548
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 53258
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091133
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 53259
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 863664
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53260
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006122
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0