CMS Formulary

Displaying 60871-60880 of 1611142 results.
ID: 60871
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 205328
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 60872
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 314155
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 60873
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 351107
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 60874
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 859193
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 60875
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 686379
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 60876
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 855818
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 60877
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 855812
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 60878
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665050
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 60879
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665093
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 60880
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665088
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0