CMS Formulary

Displaying 5821-5830 of 1611142 results.
ID: 5821
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876673
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5822
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876674
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5823
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812434
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5824
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 866111
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5825
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 198252
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5826
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649593
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 5827
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1546189
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 5828
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2261794
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 5829
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040058
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5830
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 858804
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0