CMS Formulary

Displaying 52011-52020 of 1611142 results.
ID: 52011
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191250
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52012
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 207373
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52013
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245268
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 52014
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 314088
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52015
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 403914
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52016
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 885209
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52017
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1922765
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52018
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1922763
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52019
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 105553
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52020
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 105590
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0