CMS Formulary

Displaying 52521-52530 of 1611142 results.
ID: 52521
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 310534
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52522
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1362706
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52523
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1362712
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52524
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1362720
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52525
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 308865
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 52526
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860154
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 52527
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860151
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 52528
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860127
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 52529
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 856448
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52530
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 856457
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0