CMS Formulary

Displaying 30711-30720 of 1611142 results.
ID: 30711
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 996561
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30712
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 854916
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30713
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 854919
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30714
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 854908
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30715
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 201708
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30716
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 248420
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30717
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 351172
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30718
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 199422
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30719
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 200082
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30720
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 199663
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0