CMS Formulary

Displaying 5651-5660 of 1611142 results.
ID: 5651
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 901614
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5652
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1147337
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5653
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1306298
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5654
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551999
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5655
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1484922
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 5656
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2203999
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 5657
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2204092
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 5658
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544471
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5659
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544475
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5660
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1591949
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28