CMS Formulary

Displaying 30151-30160 of 1611142 results.
ID: 30151
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 833143
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30152
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 833149
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30153
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 833146
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30154
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433250
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30155
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433223
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30156
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433229
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30157
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433235
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30158
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433241
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30159
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307309
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 30160
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2052609
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0