CMS Formulary

Displaying 52321-52330 of 1611142 results.
ID: 52321
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 835835
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52322
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115468
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52323
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1926069
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52324
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115259
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52325
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115459
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52326
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115464
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52327
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115473
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52328
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946522
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52329
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 727705
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52330
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1655728
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0