CMS Formulary

Displaying 54731-54740 of 1611142 results.
ID: 54731
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 562508
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54732
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 617430
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54733
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 199884
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54734
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 311296
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54735
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 200285
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54736
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 349353
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54737
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 636042
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54738
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 636045
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54739
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 251872
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 54740
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 314200
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30