CMS Formulary

Displaying 30221-30230 of 1611142 results.
ID: 30221
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 577957
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30222
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000114
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30223
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 199159
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30224
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000135
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30225
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000141
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30226
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197658
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30227
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197659
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30228
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197657
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30229
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 541878
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30230
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 541892
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30