CMS Formulary

Displaying 5681-5690 of 1611142 results.
ID: 5681
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801298
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5682
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801294
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5683
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1044591
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5684
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 311192
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5685
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 311197
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5686
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 311196
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5687
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 897584
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5688
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 897590
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5689
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 897596
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5690
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 317769
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0