CMS Formulary

Displaying 52991-53000 of 1611142 results.
ID: 52991
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197659
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52992
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 197657
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52993
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 541878
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 52994
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 541892
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 52995
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 577961
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 52996
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 541363
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 52997
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 751868
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52998
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 751871
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 52999
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 751870
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 53000
Formulary ID: 00021018
Formulary Version: 14
Contract Year: 2021
RXCUI: 762007
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0