CMS Formulary

Displaying 53501-53510 of 1611142 results.
ID: 53501
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 200094
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53502
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 200095
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53503
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 200096
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53504
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197311
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53505
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197313
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53506
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 313566
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53507
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 485434
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53508
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 485436
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53509
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 859424
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 53510
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 859747
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30