CMS Formulary

Displaying 5451-5460 of 1611142 results.
ID: 5451
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1550946
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5452
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 213360
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5453
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 404449
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5454
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 700418
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5455
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 404450
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5456
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1242233
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 5457
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 616116
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 5458
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 616114
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 5459
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 643714
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 5460
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1429367
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28