CMS Formulary

Displaying 59231-59240 of 1611142 results.
ID: 59231
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486981
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 59232
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486977
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 59233
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1940498
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 59234
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593831
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 59235
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593833
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 59236
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593835
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 59237
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1593775
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 59238
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 861045
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 28
ID: 59239
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 861043
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 28
ID: 59240
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 206347
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0