CMS Formulary

Displaying 59561-59570 of 1611142 results.
ID: 59561
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597123
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 59562
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597129
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 59563
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 238134
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 59564
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1745091
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 59565
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801289
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59566
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 311892
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59567
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 311893
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59568
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 199521
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 59569
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 198076
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59570
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 198077
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0