CMS Formulary

Displaying 5641-5650 of 1611142 results.
ID: 5641
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667670
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5642
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667674
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5643
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667678
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5644
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1741747
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5645
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809471
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5646
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243346
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5647
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243326
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5648
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243330
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5649
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243229
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5650
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 616148
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0