CMS Formulary

Displaying 60171-60180 of 1611142 results.
ID: 60171
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 309289
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 60172
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 309291
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 19
Qty Limit Days: 30
ID: 60173
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 895487
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 60174
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 895987
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 60175
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 797274
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 60176
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 310982
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 30
ID: 60177
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 313189
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 60178
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 197362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 60179
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 313852
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 60180
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 106336
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30