CMS Formulary

Displaying 52941-52950 of 1611142 results.
ID: 52941
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 857683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52942
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000913
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52943
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 198202
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52944
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 857677
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52945
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245443
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52946
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245373
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52947
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 309329
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52948
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 314078
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52949
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197635
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 52950
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197634
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30