CMS Formulary

Displaying 50871-50880 of 1611142 results.
ID: 50871
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 834061
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50872
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 834102
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50873
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 310436
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 50874
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 310437
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 50875
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 579148
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 50876
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 104894
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50877
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 861132
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 50878
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 310352
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50879
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 310353
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50880
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 200257
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30