CMS Formulary

Displaying 59541-59550 of 1611142 results.
ID: 59541
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 311386
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59542
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 311385
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59543
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 314075
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59544
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 310812
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59545
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 861427
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59546
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 991086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59547
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 314006
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 59548
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 315107
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 59549
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 310489
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 59550
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 722122
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30