CMS Formulary

Displaying 59321-59330 of 1611142 results.
ID: 59321
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1149632
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 59322
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 242891
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 59323
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 248478
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 59324
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000097
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59325
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 830865
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59326
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 830869
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59327
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 830872
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59328
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 260350
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59329
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 260351
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59330
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 432401
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30