CMS Formulary

Displaying 59331-59340 of 1611142 results.
ID: 59331
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000058
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59332
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 226552
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 59333
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 748878
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59334
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111641
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 59335
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487361
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 59336
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 351137
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 59337
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 351136
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 59338
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 199689
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59339
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 603208
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 59340
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 603203
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30