CMS Formulary

Displaying 5151-5160 of 1611142 results.
ID: 5151
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 203088
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 5152
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 313227
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5153
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 857366
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 170
Qty Limit Days: 30
ID: 5154
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 313226
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5155
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 848208
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5156
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 848176
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5157
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 848178
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5158
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 313200
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5159
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 103456
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5160
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 310891
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0