CMS Formulary

Displaying 53451-53460 of 1611142 results.
ID: 53451
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1361574
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53452
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 616539
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 53453
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 616541
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 53454
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 317094
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53455
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 349435
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53456
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 349434
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53457
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 310289
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53458
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 855858
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 53459
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 313306
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53460
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 348472
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0