CMS Formulary

Displaying 59941-59950 of 1611142 results.
ID: 59941
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791576
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 59942
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791582
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 59943
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812015
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59944
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 862006
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59945
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 862013
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59946
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 862019
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59947
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 862025
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59948
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665102
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59949
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1737578
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59950
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659283
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0