CMS Formulary

Displaying 49571-49580 of 1611142 results.
ID: 49571
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 830872
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 49572
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 260350
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 49573
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 260351
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 49574
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 432401
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 49575
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000058
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 49576
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 226552
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 49577
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 748878
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 49578
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111641
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 49579
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487361
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 49580
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 351137
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30