CMS Formulary

Displaying 59851-59860 of 1611142 results.
ID: 59851
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 197320
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59852
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 197527
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 59853
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 197528
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 59854
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 197529
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 59855
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 312744
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 59856
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 616487
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 59857
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 312962
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 59858
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 349332
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59859
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 351250
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59860
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 856834
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0