CMS Formulary

Displaying 50581-50590 of 1611142 results.
ID: 50581
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 2390946
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50582
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058950
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50583
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058946
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50584
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1722376
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 63
Qty Limit Days: 28
ID: 50585
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 2100099
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 180
ID: 50586
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 2100100
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 180
ID: 50587
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 312614
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50588
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 283077
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50589
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 993755
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4500
Qty Limit Days: 30
ID: 50590
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 197448
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0