CMS Formulary

Displaying 5591-5600 of 1611142 results.
ID: 5591
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 686379
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5592
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 855818
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5593
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 855812
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5594
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665050
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5595
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665093
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5596
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665088
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5597
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665046
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5598
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091650
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5599
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091654
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5600
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235150
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0