CMS Formulary

Displaying 59461-59470 of 1611142 results.
ID: 59461
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 313159
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 59462
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 197516
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59463
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 197517
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59464
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 996740
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 59465
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 311369
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 59466
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482908
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59467
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806187
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 59468
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806189
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 59469
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806191
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 59470
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806193
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30