CMS Formulary

Displaying 50771-50780 of 1611142 results.
ID: 50771
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 2180999
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50772
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1716268
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50773
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921598
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50774
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 828348
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50775
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369831
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30
ID: 50776
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870950
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 50777
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870956
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 50778
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870952
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 50779
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870960
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 50780
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870968
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 28