CMS Formulary

Displaying 59101-59110 of 1611142 results.
ID: 59101
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 977840
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 59102
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 897126
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 59103
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 2398842
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 59104
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1991311
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 59105
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1991317
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 59106
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200654
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 59107
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200658
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 59108
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 2200650
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 59109
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653204
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 59110
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 351926
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28