CMS Formulary

Displaying 59411-59420 of 1611142 results.
ID: 59411
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602594
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 59412
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1858971
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59413
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 751620
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59414
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 751623
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59415
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 751616
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59416
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 827075
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59417
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 833151
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59418
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 833139
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 59419
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 833143
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 59420
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 833149
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30