CMS Formulary

Displaying 59281-59290 of 1611142 results.
ID: 59281
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 198270
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59282
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 197960
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59283
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 198285
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59284
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 856422
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59285
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 199903
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59286
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 998671
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 59287
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 998675
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 59288
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 998679
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 59289
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000048
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59290
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 312593
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0