CMS Formulary

Displaying 52581-52590 of 1611142 results.
ID: 52581
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197405
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52582
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 103401
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52583
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 242736
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52584
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 706546
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52585
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 311033
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 52586
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 311027
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 52587
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 213442
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 52588
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860172
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 28
ID: 52589
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 2206092
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 52590
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 2206099
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28