CMS Formulary

Displaying 30761-30770 of 1611142 results.
ID: 30761
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 351108
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30762
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 349251
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30763
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 905041
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30764
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 905092
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 30765
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 905100
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 30766
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1095712
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30767
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665515
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30768
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1719286
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30769
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 313115
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30770
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 239240
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0