CMS Formulary

Displaying 50341-50350 of 1611142 results.
ID: 50341
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 312846
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50342
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 283858
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50343
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 562704
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50344
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 312849
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50345
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 997229
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 50346
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 997223
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 50347
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 993503
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50348
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 993518
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50349
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 898723
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50350
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 898687
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0