CMS Formulary

Displaying 50241-50250 of 1611142 results.
ID: 50241
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 242679
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50242
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 309313
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 600
Qty Limit Days: 30
ID: 50243
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 351285
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50244
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123194
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 50245
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 313565
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50246
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 313564
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50247
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 199885
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50248
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 242438
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50249
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 200094
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50250
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 200095
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0