CMS Formulary

Displaying 5301-5310 of 1611142 results.
ID: 5301
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 206917
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5302
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1657151
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 5303
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 749206
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5304
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659592
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5305
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659598
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5306
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 240984
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5307
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659131
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5308
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659137
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5309
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659149
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5310
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1734932
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0