CMS Formulary

Displaying 59521-59530 of 1611142 results.
ID: 59521
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 753483
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59522
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 750267
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59523
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 857560
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59524
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 312529
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59525
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 977880
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59526
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047882
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59527
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 310190
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59528
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 310191
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59529
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 261178
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 59530
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 198300
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0