CMS Formulary

Displaying 51101-51110 of 1611142 results.
ID: 51101
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 284008
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 51102
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 313919
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 51103
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797865
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 34
Qty Limit Days: 28
ID: 51104
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797867
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 25
ID: 51105
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 860107
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 25
ID: 51106
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 904481
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51107
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 617312
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51108
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 617310
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51109
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 617311
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51110
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 310818
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0