CMS Formulary

Displaying 53891-53900 of 1611142 results.
ID: 53891
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251918
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 53892
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 724142
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 53893
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 724156
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 53894
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251922
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 53895
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739788
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 600
Qty Limit Days: 30
ID: 53896
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1149617
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 53897
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 866427
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53898
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 866412
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53899
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 866419
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53900
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 198034
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0