CMS Formulary

Displaying 59571-59580 of 1611142 results.
ID: 59571
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 198078
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59572
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 198075
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59573
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 313472
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 59574
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 198153
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59575
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 905269
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59576
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 905283
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59577
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 198152
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59578
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 312615
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59579
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 197365
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59580
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 197366
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0