CMS Formulary

Displaying 50381-50390 of 1611142 results.
ID: 50381
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 796918
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50382
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649996
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 50383
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650004
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 50384
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 582984
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50385
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122661
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50386
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122659
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50387
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122657
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50388
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122655
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50389
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122650
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50390
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122648
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0