CMS Formulary

Displaying 30491-30500 of 1611142 results.
ID: 30491
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 899557
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30492
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 899518
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30493
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 899548
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30494
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091133
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 30495
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 863664
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30496
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006122
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30497
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055676
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 30498
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055672
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 30499
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 314111
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30500
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 858798
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30