CMS Formulary

Displaying 50141-50150 of 1611142 results.
ID: 50141
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 861004
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 75
Qty Limit Days: 30
ID: 50142
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 861731
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 50143
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 562524
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50144
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1652673
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50145
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650142
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50146
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 353538
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50147
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 897666
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50148
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099288
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50149
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099300
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50150
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099304
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0