CMS Formulary

Displaying 59451-59460 of 1611142 results.
ID: 59451
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 309329
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59452
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 314078
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59453
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 197635
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 59454
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 197634
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 59455
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 238154
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 59456
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 309844
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 59457
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 865117
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59458
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 865123
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59459
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 860918
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59460
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 859841
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0