CMS Formulary

Displaying 52901-52910 of 1611142 results.
ID: 52901
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307415
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 52902
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307421
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 52903
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1869699
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 52904
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1805427
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 52905
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602588
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 52906
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1805422
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 52907
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602594
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 52908
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1858971
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52909
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 751620
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52910
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 751623
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0