CMS Formulary

Displaying 5831-5840 of 1611142 results.
ID: 5831
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 794641
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5832
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 617768
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 5833
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790892
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5834
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790886
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5835
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790890
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5836
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2384465
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 28
ID: 5837
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1670324
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 80
Qty Limit Days: 28
ID: 5838
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1670322
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 28
ID: 5839
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 309952
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5840
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197622
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0