CMS Formulary

Displaying 54891-54900 of 1611142 results.
ID: 54891
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 309113
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54892
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 200345
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 54893
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197903
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54894
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197904
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54895
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197905
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54896
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 311353
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54897
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 311354
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54898
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197884
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54899
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197885
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54900
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197886
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0