CMS Formulary

Displaying 51501-51510 of 1611142 results.
ID: 51501
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 402246
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51502
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 402247
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51503
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 664741
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51504
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 833528
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51505
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 722134
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51506
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 722137
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51507
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 722126
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51508
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 722131
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51509
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 860715
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 51510
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 860695
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30