CMS Formulary

Displaying 30001-30010 of 1611142 results.
ID: 30001
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 856706
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30002
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 856429
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30003
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 310670
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30004
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373483
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 7
ID: 30005
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373491
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30006
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 856797
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30007
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 866491
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30008
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197963
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30009
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 856825
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30010
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 313354
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0