CMS Formulary

Displaying 54991-55000 of 1611142 results.
ID: 54991
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 310433
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 54992
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 310434
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 54993
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 403966
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54994
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 403967
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54995
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1358776
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54996
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 309367
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54997
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 198014
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54998
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 311753
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 54999
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197891
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 55000
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197892
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0