CMS Formulary

Displaying 51231-51240 of 1611142 results.
ID: 51231
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 403853
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51232
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 403854
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51233
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 403855
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51234
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 859981
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 51235
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 859975
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 51236
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 849389
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51237
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 313407
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51238
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 313408
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51239
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1536490
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51240
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 310878
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0