CMS Formulary

Displaying 60781-60790 of 1611142 results.
ID: 60781
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 401953
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 60782
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 401954
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 60783
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 616698
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 60784
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 616705
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 60785
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 312635
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 60786
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 198365
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 60787
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 995666
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 60788
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 198145
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 60789
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 313215
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 60790
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 313217
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0