CMS Formulary

Displaying 54821-54830 of 1611142 results.
ID: 54821
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 861363
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54822
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 861365
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54823
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 861356
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54824
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1737244
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54825
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1737581
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54826
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 2048025
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54827
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 404419
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54828
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 106351
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54829
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 198241
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 54830
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 198242
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30