CMS Formulary

Displaying 30461-30470 of 1611142 results.
ID: 30461
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 403890
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30462
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197549
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30463
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197550
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30464
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102717
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30465
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102713
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30466
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102715
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30467
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2475840
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 560
Qty Limit Days: 28
ID: 30468
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2107621
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 30469
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719862
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30470
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719803
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0