CMS Formulary

Displaying 5891-5900 of 1611142 results.
ID: 5891
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 866907
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5892
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000133
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5893
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801519
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 5894
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 539789
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 5895
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 856666
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 5896
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 979115
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 5897
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244062
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 5898
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244064
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 11
Qty Limit Days: 28
ID: 5899
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1596778
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5900
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1673274
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28