CMS Formulary

Displaying 5461-5470 of 1611142 results.
ID: 5461
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 643722
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 5462
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369724
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 5463
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369728
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 5464
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369732
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 5465
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369736
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 5466
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1940376
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5467
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1940372
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5468
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2197501
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 5469
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2396770
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 28
ID: 5470
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2396774
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 28