CMS Formulary

Displaying 5041-5050 of 1611142 results.
ID: 5041
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1735496
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5042
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1147228
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 5043
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2197873
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 5044
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2197877
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 5045
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 205532
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5046
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1592285
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 5047
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1868016
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 5048
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1868020
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 5049
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1727485
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 5050
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1441530
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0