CMS Formulary

Displaying 52791-52800 of 1611142 results.
ID: 52791
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 892246
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52792
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 966248
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52793
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 966224
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52794
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 966225
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52795
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 966249
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52796
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 892251
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52797
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 892255
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52798
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 966270
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52799
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 349477
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52800
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 198324
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0