CMS Formulary

Displaying 51121-51130 of 1611142 results.
ID: 51121
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 855812
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 51122
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665050
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51123
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665093
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51124
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665088
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51125
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51126
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091650
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51127
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091654
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51128
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235150
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51129
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235157
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51130
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 310467
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0