CMS Formulary

Displaying 30331-30340 of 1611142 results.
ID: 30331
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243040
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30332
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243026
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30333
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1545664
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30334
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1545668
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30335
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1651275
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 30336
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1664321
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30337
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1667882
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 30338
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665369
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30339
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1664328
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30340
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1664325
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30