CMS Formulary

Displaying 5071-5080 of 1611142 results.
ID: 5071
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1439894
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 5072
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1439896
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 5073
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1439899
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 5074
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1439901
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 5075
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1439903
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 5076
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105657
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 5077
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105645
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5078
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105653
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 5079
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2180336
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 5080
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 615979
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30