CMS Formulary

Displaying 5111-5120 of 1611142 results.
ID: 5111
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251918
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5112
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 724142
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5113
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 724156
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5114
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251922
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5115
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1739788
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 600
Qty Limit Days: 30
ID: 5116
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1149617
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 5117
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 866427
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5118
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 866412
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5119
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 866419
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5120
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198034
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0