CMS Formulary

Displaying 54511-54520 of 1611142 results.
ID: 54511
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 2360548
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54512
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 308989
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54513
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 308988
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54514
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197443
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54515
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099678
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54516
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099870
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54517
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356563
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 54518
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356572
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 54519
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356576
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 54520
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356580
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30