CMS Formulary

Displaying 60131-60140 of 1611142 results.
ID: 60131
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 751570
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 60132
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 897044
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 60133
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 758032
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 60134
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 758027
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 60135
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650282
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 60136
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 207836
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 60137
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 796918
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 60138
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649996
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 60139
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650004
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 60140
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 582984
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0