CMS Formulary

Displaying 58951-58960 of 1611142 results.
ID: 58951
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 314234
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58952
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 308177
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58953
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 598025
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58954
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 617309
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58955
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 617316
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58956
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 617296
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58957
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 636664
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58958
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 608328
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58959
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148141
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 58960
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 861960
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30