CMS Formulary

Displaying 54201-54210 of 1611142 results.
ID: 54201
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049586
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 54202
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049595
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 54203
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049601
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 54204
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544404
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54205
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544383
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54206
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544386
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54207
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544388
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54208
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544390
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54209
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544394
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54210
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544396
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0