CMS Formulary

Displaying 51691-51700 of 1611142 results.
ID: 51691
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 205315
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51692
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 313583
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 51693
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 313585
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 51694
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 992438
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51695
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 992447
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51696
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 310672
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51697
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 314035
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51698
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 197754
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51699
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 686924
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51700
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 200032
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0