CMS Formulary

Displaying 60361-60370 of 1611142 results.
ID: 60361
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105645
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 60362
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105653
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 60363
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 2180336
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 60364
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 615979
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 60365
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 207059
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 60366
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 211140
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 60367
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 706831
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 60368
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 706827
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 60369
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 706829
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 60370
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 706825
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28