CMS Formulary

Displaying 59441-59450 of 1611142 results.
ID: 59441
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 630208
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 59442
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 245314
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 59443
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 485968
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 59444
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 991061
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59445
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 857683
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59446
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000913
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59447
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 198202
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59448
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 857677
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59449
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245443
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59450
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245373
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0