CMS Formulary

Displaying 53291-53300 of 1611142 results.
ID: 53291
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 402131
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 53292
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 349545
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 53293
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 349490
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 53294
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 349553
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 53295
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 349547
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 53296
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 856373
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53297
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 310288
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53298
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197985
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53299
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197984
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53300
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 598006
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0