CMS Formulary

Displaying 5181-5190 of 1611142 results.
ID: 5181
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 402505
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5182
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 402506
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5183
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1313885
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5184
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 577237
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5185
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 310285
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5186
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198359
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5187
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 389242
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5188
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 204119
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5189
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2287905
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 5190
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2056700
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30