CMS Formulary

Displaying 51081-51090 of 1611142 results.
ID: 51081
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 197625
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51082
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 197626
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51083
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 197627
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51084
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 197628
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51085
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 199390
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51086
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 197553
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51087
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 328160
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51088
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 310490
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 51089
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 310488
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 51090
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 993687
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0