CMS Formulary

Displaying 59551-59560 of 1611142 results.
ID: 59551
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 722116
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 59552
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 198250
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59553
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 197502
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59554
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 897612
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59555
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 897618
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59556
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 897624
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59557
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 897630
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59558
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 312025
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59559
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 198041
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59560
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 582926
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0