CMS Formulary

Displaying 59681-59690 of 1611142 results.
ID: 59681
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 403851
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59682
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 810083
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59683
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 403852
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59684
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 730988
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59685
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 349556
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 59686
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 240741
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59687
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 309322
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59688
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 476576
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59689
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 617423
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59690
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 617993
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0