CMS Formulary

Displaying 53331-53340 of 1611142 results.
ID: 53331
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 198211
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 53332
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 200060
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53333
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 317573
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 53334
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 312440
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 53335
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 312441
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 53336
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 199123
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53337
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197956
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53338
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197958
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53339
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 200064
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53340
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 199224
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0