CMS Formulary

Displaying 5051-5060 of 1611142 results.
ID: 5051
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1242998
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5052
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2106075
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5053
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2390946
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5054
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058950
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5055
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058946
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5056
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1722376
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 63
Qty Limit Days: 28
ID: 5057
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2100099
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 180
ID: 5058
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2100100
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 180
ID: 5059
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 312614
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5060
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 283077
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0