CMS Formulary

Displaying 54411-54420 of 1611142 results.
ID: 54411
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197310
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54412
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 309045
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54413
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197449
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54414
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946772
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54415
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 198181
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54416
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 251322
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54417
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 763457
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54418
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653792
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 54419
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719766
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 54420
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667666
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30