CMS Formulary

Displaying 5031-5040 of 1611142 results.
ID: 5031
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198372
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5032
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198369
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5033
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198370
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5034
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1242819
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 56
ID: 5035
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1242815
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 56
ID: 5036
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 616749
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5037
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 728231
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5038
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1657212
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5039
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1735537
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5040
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 992403
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0