CMS Formulary

Displaying 58991-59000 of 1611142 results.
ID: 58991
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860157
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 58992
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860129
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 58993
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860137
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 58994
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860148
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 58995
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 835894
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58996
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 835925
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58997
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 241834
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58998
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1368954
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 58999
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 349094
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59000
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 351109
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0