CMS Formulary

Displaying 53801-53810 of 1611142 results.
ID: 53801
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1660690
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53802
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 2397128
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53803
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 314106
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53804
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 311681
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53805
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 856377
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53806
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 308460
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53807
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 749783
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53808
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 248656
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53809
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 749780
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53810
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 204844
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0