CMS Formulary

Displaying 52571-52580 of 1611142 results.
ID: 52571
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 313797
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52572
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 239191
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52573
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665052
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52574
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665444
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52575
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665449
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52576
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 313920
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52577
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 106258
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52578
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 203105
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52579
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197409
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52580
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197408
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0