CMS Formulary

Displaying 5261-5270 of 1611142 results.
ID: 5261
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 96304
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5262
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 998689
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5263
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 998685
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5264
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099686
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 5265
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099691
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 5266
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099697
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 5267
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1313785
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5268
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 207588
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5269
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 213510
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5270
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 310386
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0