CMS Formulary

Displaying 5321-5330 of 1611142 results.
ID: 5321
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649964
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5322
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 993456
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 180
ID: 5323
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1046402
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5324
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649491
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5325
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649495
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5326
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2168596
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5327
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2045638
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 5328
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2120195
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 5329
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123191
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 5330
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 727537
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0