CMS Formulary

Displaying 52951-52960 of 1611142 results.
ID: 52951
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 238154
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 52952
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 309844
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 52953
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 865117
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52954
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 865123
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52955
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 860918
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52956
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 859841
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52957
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 313159
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 52958
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197516
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52959
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197517
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52960
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 996740
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30