CMS Formulary

Displaying 5061-5070 of 1611142 results.
ID: 5061
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 993755
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4500
Qty Limit Days: 30
ID: 5062
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197448
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5063
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923432
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5064
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 477391
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5065
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197877
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5066
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010739
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5067
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 391937
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5068
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197305
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5069
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 212787
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5070
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1312408
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28