CMS Formulary

Displaying 59001-59010 of 1611142 results.
ID: 59001
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098666
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59002
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098678
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59003
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 904467
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59004
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 904475
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59005
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490065
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59006
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 199058
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59007
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 596843
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 59008
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 308868
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59009
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 403879
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 59010
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 476556
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0