CMS Formulary

Displaying 30271-30280 of 1611142 results.
ID: 30271
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197901
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 30272
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197902
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 30273
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 311386
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30274
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 311385
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30275
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 314075
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30276
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 310812
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30277
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 861427
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30278
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 991086
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30279
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 314006
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30280
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 315107
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30