CMS Formulary

Displaying 5771-5780 of 1611142 results.
ID: 5771
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049271
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5772
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049278
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5773
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197518
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5774
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 284215
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5775
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 544840
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5776
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 313165
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 5777
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 865129
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5778
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1807513
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5779
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 312447
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5780
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 597823
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0