CMS Formulary

Displaying 5741-5750 of 1611142 results.
ID: 5741
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356584
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5742
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356588
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5743
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790126
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 720
Qty Limit Days: 30
ID: 5744
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 824299
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5745
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 824303
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5746
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054157
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5747
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796665
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5748
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1604384
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5749
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054159
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5750
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1604350
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0