CMS Formulary

Displaying 59021-59030 of 1611142 results.
ID: 59021
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299903
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59022
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000695
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59023
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1299909
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59024
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 197737
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59025
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 310534
NDC:
Tier Level: 6
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59026
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1362706
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59027
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1362712
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59028
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1362720
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59029
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 308865
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 59030
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860154
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30