CMS Formulary

Displaying 54291-54300 of 1611142 results.
ID: 54291
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 861064
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54292
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197787
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54293
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197782
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54294
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197783
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54295
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 313142
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54296
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 312347
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54297
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1048450
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54298
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1020065
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 54299
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1048445
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54300
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 855626
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30