CMS Formulary

Displaying 53511-53520 of 1611142 results.
ID: 53511
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 859751
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 53512
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 859419
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 53513
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 199192
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53514
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 199193
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53515
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 198382
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53516
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 997226
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 53517
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 997220
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 53518
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 349201
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53519
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 200034
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 53520
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 312078
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30