CMS Formulary

Displaying 54111-54120 of 1611142 results.
ID: 54111
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648162
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54112
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648160
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54113
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 2048718
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 54114
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 2048722
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 54115
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1991509
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54116
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1865962
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54117
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197699
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54118
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197700
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54119
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 596926
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 54120
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 596930
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30