CMS Formulary

Displaying 54581-54590 of 1611142 results.
ID: 54581
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371062
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 54582
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371066
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 54583
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482513
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 54584
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482517
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 54585
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482523
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 54586
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482527
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 54587
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235249
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 54588
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040036
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 54589
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1431237
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 54590
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040043
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30