CMS Formulary

Displaying 30621-30630 of 1611142 results.
ID: 30621
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 897683
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30622
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 314184
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30623
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 310537
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30624
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 897722
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30625
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197942
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30626
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197941
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30627
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 861007
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 30628
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 861010
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 30629
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 861004
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 75
Qty Limit Days: 30
ID: 30630
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 861731
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30