CMS Formulary

Displaying 51181-51190 of 1611142 results.
ID: 51181
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1306298
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51182
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551999
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 51183
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1484922
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 51184
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 2203999
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 51185
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 2204092
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 51186
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544471
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 51187
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544475
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 51188
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1591949
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 51189
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 2204104
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 51190
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 2204102
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28