CMS Formulary

Displaying 5361-5370 of 1611142 results.
ID: 5361
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 866514
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5362
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 476809
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5363
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197499
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5364
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197500
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5365
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1662285
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5366
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 984082
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5367
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551923
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5368
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601373
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5369
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1654079
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5370
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 853354
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0