CMS Formulary

Displaying 5731-5740 of 1611142 results.
ID: 5731
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2360548
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5732
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 308989
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5733
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 308988
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5734
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197443
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5735
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099678
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5736
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099870
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5737
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356563
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5738
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356572
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5739
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356576
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5740
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356580
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30