CMS Formulary

Displaying 30091-30100 of 1611142 results.
ID: 30091
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 857005
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 30092
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 856999
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 30093
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 993781
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 30094
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049221
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 30095
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049225
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 30096
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049214
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 30097
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091497
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 30098
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091392
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 30099
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806181
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30100
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1806197
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30