CMS Formulary

Displaying 59431-59440 of 1611142 results.
ID: 59431
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300797
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59432
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300803
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59433
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 967388
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59434
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 307730
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59435
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 106302
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59436
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 884308
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 59437
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 106387
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59438
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 308714
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 59439
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 755497
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59440
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 992765
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0