CMS Formulary

Displaying 59491-59500 of 1611142 results.
ID: 59491
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 199159
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59492
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000135
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59493
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000141
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59494
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 197658
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59495
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 197659
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59496
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 197657
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59497
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 541878
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 59498
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 541892
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 59499
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 577961
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 59500
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 541363
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30