CMS Formulary

Displaying 53761-53770 of 1611142 results.
ID: 53761
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 2374566
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53762
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790146
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53763
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197839
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53764
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 313447
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53765
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 835593
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53766
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 835564
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53767
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 835568
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53768
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197739
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53769
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 896758
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53770
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 896762
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0