CMS Formulary

Displaying 5661-5670 of 1611142 results.
ID: 5661
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2204104
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 5662
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2204102
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 5663
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721619
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5664
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747697
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5665
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1741739
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5666
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799218
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 5667
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2288816
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 5668
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1858267
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5669
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1939335
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 5670
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999673
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0