CMS Formulary

Displaying 5411-5420 of 1611142 results.
ID: 5411
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547231
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5412
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110618
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5413
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114074
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5414
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114096
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5415
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 903841
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5416
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114470
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5417
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049504
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5418
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049545
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5419
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049565
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5420
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049576
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30