CMS Formulary

Displaying 5431-5440 of 1611142 results.
ID: 5431
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544398
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5432
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544402
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5433
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659818
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 5434
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659814
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 5435
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658325
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 5436
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658329
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5437
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658333
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5438
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658337
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5439
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658341
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5440
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658345
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30