CMS Formulary

Displaying 30341-30350 of 1611142 results.
ID: 30341
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1546083
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 30342
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796091
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30343
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796096
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30344
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862688
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30345
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862701
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30346
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862697
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30347
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862692
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30348
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1037181
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30349
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1037049
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30350
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 991082
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0