CMS Formulary

Displaying 49521-49530 of 1611142 results.
ID: 49521
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 856825
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 49522
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 313354
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 49523
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 198274
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 49524
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 198275
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 49525
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 198270
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 49526
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 197960
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 49527
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 198285
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 49528
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 856422
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 49529
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 199903
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 49530
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 998671
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28