CMS Formulary

Displaying 59011-59020 of 1611142 results.
ID: 59011
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 197535
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 59012
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 310295
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 59013
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 310297
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 59014
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 313992
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 59015
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 313993
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 59016
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 310293
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 59017
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 310294
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 59018
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 314000
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59019
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 310536
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59020
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 310539
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0