CMS Formulary

Displaying 5491-5500 of 1611142 results.
ID: 5491
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364515
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5492
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2373941
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5493
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049677
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5494
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 762675
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5495
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 259966
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5496
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197973
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5497
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 401953
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5498
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 401954
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5499
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 616698
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 5500
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 616705
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30