CMS Formulary

Displaying 54491-54500 of 1611142 results.
ID: 54491
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1536490
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54492
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 310878
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54493
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 311982
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54494
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 104884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54495
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 861430
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54496
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 886662
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54497
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 886666
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54498
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 886671
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54499
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 686400
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54500
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190572
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0