CMS Formulary

Displaying 59221-59230 of 1611142 results.
ID: 59221
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 2289428
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 59222
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1942485
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 59223
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1942489
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 59224
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047639
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 59225
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053927
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 59226
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721571
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 59227
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721583
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 59228
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989109
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 59229
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 2205634
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 59230
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 2387331
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 28