CMS Formulary

Displaying 5801-5810 of 1611142 results.
ID: 5801
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371062
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 5802
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371066
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 5803
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482513
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5804
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482517
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5805
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482523
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5806
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482527
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5807
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235249
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5808
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040036
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5809
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1431237
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5810
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040043
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30