CMS Formulary

Displaying 30071-30080 of 1611142 results.
ID: 30071
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 603208
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30072
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 603203
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30073
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 603206
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 30074
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 748961
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30075
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 751901
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 30076
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 810096
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 30077
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 749761
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 30078
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 748868
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30079
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 759743
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30080
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 748806
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0