CMS Formulary

Displaying 5251-5260 of 1611142 results.
ID: 5251
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870960
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5252
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870968
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 28
ID: 5253
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1304985
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 5254
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1811182
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 5255
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649405
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5256
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 313096
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5257
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 318179
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5258
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 283535
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5259
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198222
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5260
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198150
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0