CMS Formulary

Displaying 5881-5890 of 1611142 results.
ID: 5881
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244214
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5882
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 197312
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 5883
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 485496
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 5884
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 348719
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5885
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110774
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 5886
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110777
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 5887
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110780
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 5888
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110783
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 5889
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110786
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 5890
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2183131
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30