CMS Formulary

Displaying 5281-5290 of 1611142 results.
ID: 5281
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198051
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5282
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 312077
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5283
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 313412
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5284
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 313413
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5285
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 314286
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5286
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 313776
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5287
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 313777
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5288
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 313778
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5289
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 314214
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5290
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 312835
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30