CMS Formulary

Displaying 54771-54780 of 1611142 results.
ID: 54771
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 897021
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 54772
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049264
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 54773
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1856424
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54774
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 2052064
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54775
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 861375
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54776
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 861370
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54777
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373745
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54778
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 485442
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 54779
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 485465
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 54780
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 352066
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30