CMS Formulary

Displaying 5401-5410 of 1611142 results.
ID: 5401
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 830463
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5402
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601407
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5403
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 809159
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5404
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 802652
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5405
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653225
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5406
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2182340
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5407
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2392142
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5408
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 261105
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5409
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310531
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5410
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310535
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30