CMS Formulary

Displaying 30541-30550 of 1611142 results.
ID: 30541
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 284496
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30542
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 855926
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30543
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 855906
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 30544
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 855664
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 30545
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 995281
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30546
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1095227
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30547
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1304988
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30548
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1661092
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 30549
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 309079
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30550
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1438778
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0