CMS Formulary

Displaying 30161-30170 of 1611142 results.
ID: 30161
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2052704
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30162
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105817
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 30163
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300797
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30164
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300803
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30165
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 967388
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30166
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 307730
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30167
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 106302
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30168
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 884308
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30169
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 106387
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30170
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 308714
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30