CMS Formulary

Displaying 5901-5910 of 1611142 results.
ID: 5901
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1673278
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 5902
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1673280
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 5903
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 1925264
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 56
ID: 5904
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049343
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 365
ID: 5905
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 312941
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5906
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 312938
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5907
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 308194
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5908
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 308182
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5909
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 283406
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 5910
Formulary ID: 00021001
Formulary Version: 14
Contract Year: 2021
RXCUI: 283407
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0