CMS Formulary

Displaying 5201-5210 of 1611142 results.
ID: 5201
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 903703
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5202
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 313195
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5203
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198240
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5204
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 748865
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5205
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 749848
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5206
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 753544
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5207
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 750244
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5208
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806177
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5209
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806185
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5210
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2468058
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0