CMS Formulary

Displaying 5001-5010 of 1611142 results.
ID: 5001
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 403825
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5002
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 312439
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5003
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198103
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5004
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 250820
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 5005
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 858751
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5006
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 858733
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5007
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 848943
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5008
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801279
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5009
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486687
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5010
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197797
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0