CMS Formulary

Displaying 51461-51470 of 1611142 results.
ID: 51461
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 979485
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51462
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 979492
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51463
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 979480
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51464
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 248109
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51465
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 314108
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51466
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 311290
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51467
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 854984
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51468
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 854988
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51469
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 854925
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51470
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 904431
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28