CMS Formulary

Displaying 5241-5250 of 1611142 results.
ID: 5241
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191302
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5242
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 310152
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 5243
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2180999
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5244
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1716268
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5245
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921598
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5246
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 828348
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5247
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369831
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30
ID: 5248
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870950
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5249
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870956
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5250
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870952
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30