CMS Formulary

Displaying 5351-5360 of 1611142 results.
ID: 5351
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 310353
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5352
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 200257
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 5353
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 200256
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 5354
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 200258
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 5355
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 313582
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5356
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 313584
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5357
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 314277
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5358
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 313586
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5359
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 311759
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5360
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 866511
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0