CMS Formulary

Displaying 60031-60040 of 1611142 results.
ID: 60031
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 905041
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 60032
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 905092
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 60033
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 905100
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 60034
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1095712
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 60035
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665515
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 60036
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719286
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 60037
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 313115
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 60038
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 239240
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 60039
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 809871
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 30
ID: 60040
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 864661
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0