CMS Formulary

Displaying 5481-5490 of 1611142 results.
ID: 5481
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 794610
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5482
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 831870
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5483
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 850457
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5484
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1236632
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5485
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359271
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5486
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 758555
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5487
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1052660
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5488
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1250723
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5489
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1600710
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5490
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999587
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30