CMS Formulary

Displaying 51921-51930 of 1611142 results.
ID: 51921
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 349287
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51922
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1927682
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 14
ID: 51923
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 313362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51924
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 313364
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51925
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 313361
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51926
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 197558
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51927
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 197557
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51928
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 903843
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51929
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1661799
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 51930
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946589
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 32
Qty Limit Days: 30