CMS Formulary

Displaying 5751-5760 of 1611142 results.
ID: 5751
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1792393
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5752
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1604395
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5753
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1604352
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5754
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 825335
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5755
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 825333
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5756
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 825325
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5757
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 825334
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5758
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 212118
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5759
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 542370
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5760
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988768
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30