CMS Formulary

Displaying 50881-50890 of 1611142 results.
ID: 50881
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 200256
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 50882
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 200258
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 50883
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 313582
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50884
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 313584
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50885
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 314277
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50886
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 313586
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50887
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 311759
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50888
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 866511
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50889
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 866514
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50890
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 476809
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0