CMS Formulary

Displaying 30141-30150 of 1611142 results.
ID: 30141
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602588
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30142
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1805422
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30143
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602594
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30144
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1858971
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30145
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 751620
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30146
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 751623
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30147
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 751616
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30148
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 827075
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30149
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 833151
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30150
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 833139
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30