CMS Formulary

Displaying 54171-54180 of 1611142 results.
ID: 54171
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300810
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54172
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 798430
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54173
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 798428
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54174
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986830
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 365
ID: 54175
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 798482
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54176
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 798479
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54177
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300378
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54178
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300370
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54179
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 805579
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54180
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 901518
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0