CMS Formulary

Displaying 50901-50910 of 1611142 results.
ID: 50901
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653144
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50902
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482814
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50903
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653166
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50904
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1100079
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 50905
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1918044
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 50906
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1928689
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50907
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 2118741
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 50908
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000019
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 50909
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1994362
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 50910
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1442992
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30