CMS Formulary

Displaying 54341-54350 of 1611142 results.
ID: 54341
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 310488
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 54342
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 993687
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54343
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 993691
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54344
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 903887
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54345
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 903891
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54346
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 903884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54347
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 242446
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54348
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 857700
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 54349
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 213291
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54350
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111339
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0