CMS Formulary

Displaying 59071-59080 of 1611142 results.
ID: 59071
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 835840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59072
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 835809
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 28
ID: 59073
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649988
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59074
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 308189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59075
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 313797
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59076
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 239191
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59077
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665052
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59078
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665444
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59079
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665449
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59080
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 313920
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0