CMS Formulary

Displaying 52691-52700 of 1611142 results.
ID: 52691
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 832731
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52692
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801295
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52693
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123111
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 52694
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 198071
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52695
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197541
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 52696
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 753478
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52697
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 753479
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52698
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1428933
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52699
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091828
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52700
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 351173
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0