CMS Formulary

Displaying 54551-54560 of 1611142 results.
ID: 54551
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049271
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 54552
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049278
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 54553
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197518
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54554
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 284215
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54555
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 544840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54556
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 313165
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 54557
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 865129
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54558
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1807513
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54559
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 312447
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54560
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 597823
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0