CMS Formulary

Displaying 54791-54800 of 1611142 results.
ID: 54791
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729047
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 54792
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729076
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54793
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 2261800
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 54794
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799001
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54795
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790317
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54796
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 727714
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54797
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 314230
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54798
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 861646
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 54799
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 861650
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 54800
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 861654
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30