CMS Formulary

Displaying 54081-54090 of 1611142 results.
ID: 54081
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 206917
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54082
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1657151
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 54083
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 749206
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54084
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659592
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54085
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659598
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54086
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 240984
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54087
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659131
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54088
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659137
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54089
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659149
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54090
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1734932
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0