CMS Formulary

Displaying 59911-59920 of 1611142 results.
ID: 59911
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 896766
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59912
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 309044
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59913
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 313888
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59914
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 309042
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59915
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 309683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59916
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1012021
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59917
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 849506
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59918
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797863
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 50
Qty Limit Days: 25
ID: 59919
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 213262
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59920
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 545259
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0