CMS Formulary

Displaying 54971-54980 of 1611142 results.
ID: 54971
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 577317
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54972
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 836395
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 54973
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 833234
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54974
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 905158
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54975
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 199376
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54976
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 199381
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54977
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 898490
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54978
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 686429
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54979
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988308
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54980
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988311
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0