CMS Formulary

Displaying 51131-51140 of 1611142 results.
ID: 51131
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 310377
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51132
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 745462
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51133
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 731566
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51134
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 731568
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51135
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 731571
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51136
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049223
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 51137
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049227
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 51138
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049216
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 51139
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 854801
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51140
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 313477
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0