CMS Formulary

Displaying 30101-30110 of 1611142 results.
ID: 30101
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 897696
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 30102
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 897702
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 30103
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 897710
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 30104
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 864706
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 30105
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049611
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 30106
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049618
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 30107
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 245136
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 30108
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 245134
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 30109
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 245135
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 30110
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197696
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30