CMS Formulary

Displaying 54781-54790 of 1611142 results.
ID: 54781
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 656660
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 54782
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989085
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 54783
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1442143
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 54784
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729053
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 54785
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729057
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 54786
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729061
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 54787
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729065
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 54788
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729013
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 54789
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729029
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 54790
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729033
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30