CMS Formulary

Displaying 54321-54330 of 1611142 results.
ID: 54321
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 309686
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54322
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 312055
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 54323
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085745
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54324
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 992432
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54325
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000054
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54326
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 831215
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54327
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 831252
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54328
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 831285
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54329
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 312301
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54330
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197684
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0