CMS Formulary

Displaying 5231-5240 of 1611142 results.
ID: 5231
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 313496
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5232
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111110
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 10
ID: 5233
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2279847
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 10
ID: 5234
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1001690
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5235
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2465556
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5236
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 905394
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5237
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 404539
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5238
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1543069
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 5239
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010878
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5240
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085741
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0