CMS Formulary

Displaying 59961-59970 of 1611142 results.
ID: 59961
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 310289
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59962
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 855858
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 59963
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 313306
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59964
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 348472
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59965
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 282401
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59966
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 198427
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59967
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 198428
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59968
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 198429
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59969
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 152695
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59970
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 854905
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0