CMS Formulary

Displaying 30131-30140 of 1611142 results.
ID: 30131
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040012
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30132
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040016
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30133
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653470
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30134
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1086776
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30135
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1086780
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30136
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1086786
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30137
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307415
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30138
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307421
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30139
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1869699
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30140
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1805427
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30