CMS Formulary

Displaying 59091-59100 of 1611142 results.
ID: 59091
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 213442
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 59092
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860172
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 28
ID: 59093
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 2206092
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 59094
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 2206099
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 59095
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049380
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 59096
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986354
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 59097
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986356
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 59098
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 2205454
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 59099
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653198
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 59100
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 977842
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28