CMS Formulary

Displaying 30481-30490 of 1611142 results.
ID: 30481
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1540356
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30482
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 992475
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30483
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 995258
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30484
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1297753
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30485
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1297757
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30486
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049621
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 30487
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2101899
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30488
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049683
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 30489
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049686
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 30490
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091150
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30