CMS Formulary

Displaying 54841-54850 of 1611142 results.
ID: 54841
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 199206
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 54842
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197805
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54843
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197806
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54844
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197807
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54845
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 311347
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54846
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 311204
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54847
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 898715
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 54848
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 282755
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54849
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 205304
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54850
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 205305
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0