CMS Formulary

Displaying 5391-5400 of 1611142 results.
ID: 5391
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300810
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5392
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 798430
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5393
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 798428
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5394
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986830
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 365
ID: 5395
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 798482
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5396
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 798479
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5397
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300378
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5398
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300370
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5399
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 805579
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5400
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 901518
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0