CMS Formulary

Displaying 52861-52870 of 1611142 results.
ID: 52861
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091497
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 52862
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091392
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 52863
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806181
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 52864
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806197
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 52865
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 897696
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 52866
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 897702
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 52867
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 897710
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 52868
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 864706
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 52869
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049611
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 52870
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049618
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30