CMS Formulary

Displaying 5381-5390 of 1611142 results.
ID: 5381
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1994362
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 5382
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1442992
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 5383
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000023
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 5384
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000027
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 5385
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000031
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 5386
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300386
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5387
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 829989
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5388
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 830552
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5389
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 830557
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5390
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 803371
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0