CMS Formulary

Displaying 53311-53320 of 1611142 results.
ID: 53311
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1304988
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53312
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1661092
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 53313
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 309079
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53314
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1438778
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53315
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1440937
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53316
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1440183
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53317
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1537209
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53318
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53319
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1539953
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53320
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1539955
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0