CMS Formulary

Displaying 53671-53680 of 1611142 results.
ID: 53671
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 797274
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53672
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 310982
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 30
ID: 53673
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 313189
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 53674
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53675
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 313852
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53676
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 106336
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 53677
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 543460
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53678
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197574
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 53679
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 309333
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 53680
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 855168
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0