CMS Formulary

Displaying 30081-30090 of 1611142 results.
ID: 30081
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 748804
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30082
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 284191
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30083
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 310169
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30084
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 861657
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30085
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 486148
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30086
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 486152
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30087
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 486146
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30088
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 577057
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 30089
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437702
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30
ID: 30090
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 857002
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30