CMS Formulary

Displaying 52281-52290 of 1611142 results.
ID: 52281
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 2048568
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52282
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 2478437
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52283
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099956
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 52284
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058926
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 52285
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047602
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 52286
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047608
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 52287
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047614
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 52288
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047596
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 52289
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047623
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 52290
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 2463737
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28