CMS Formulary

Displaying 5631-5640 of 1611142 results.
ID: 5631
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197310
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5632
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 309045
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5633
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197449
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5634
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1946772
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5635
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198181
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5636
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 251322
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5637
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 763457
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5638
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653792
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5639
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719766
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5640
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667666
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30