CMS Formulary

Displaying 30671-30680 of 1611142 results.
ID: 30671
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791560
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30672
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791569
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30673
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791576
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 30674
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1791582
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 30675
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812015
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30676
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 862006
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30677
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 862013
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30678
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 862019
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30679
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 862025
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30680
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665102
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0