CMS Formulary

Displaying 53341-53350 of 1611142 results.
ID: 53341
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 313190
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53342
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 198377
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53343
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 198378
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53344
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1483744
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53345
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 310346
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53346
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197319
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53347
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197320
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53348
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197527
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 53349
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197528
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 53350
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197529
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30