CMS Formulary

Displaying 59641-59650 of 1611142 results.
ID: 59641
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 198159
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59642
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191256
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59643
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 992459
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59644
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 311678
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59645
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085728
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59646
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191315
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59647
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 628953
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59648
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 381056
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59649
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 206842
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59650
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 198316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0