CMS Formulary

Displaying 51521-51530 of 1611142 results.
ID: 51521
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1856424
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51522
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 2052064
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51523
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 861375
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51524
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 861370
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51525
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373745
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51526
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 485442
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 51527
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 485465
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 51528
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 352066
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 51529
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 656660
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 51530
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989085
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28