CMS Formulary

Displaying 53751-53760 of 1611142 results.
ID: 53751
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796079
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53752
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796083
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53753
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433879
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53754
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1546894
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53755
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1857913
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53756
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1857917
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53757
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1857925
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53758
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989506
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53759
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122526
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53760
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 2380551
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0