CMS Formulary

Displaying 51771-51780 of 1611142 results.
ID: 51771
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 200329
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51772
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 864681
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51773
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 307731
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51774
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 864675
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51775
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 835726
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51776
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 349373
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51777
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 857216
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51778
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 857224
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51779
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 314266
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 51780
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 749784
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0