CMS Formulary

Displaying 51841-51850 of 1611142 results.
ID: 51841
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 200311
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51842
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 310431
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 51843
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 728113
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 48
Qty Limit Days: 180
ID: 51844
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 483442
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 51845
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 483448
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 51846
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 483446
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 51847
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 312515
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51848
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1795598
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51849
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1366192
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 51850
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796922
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0