CMS Formulary

Displaying 50731-50740 of 1611142 results.
ID: 50731
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 198240
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50732
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 748865
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50733
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 749848
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50734
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 753544
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50735
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 750244
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50736
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806177
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 50737
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806185
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 50738
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 2468058
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50739
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 2471314
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50740
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 748962
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0