CMS Formulary

Displaying 30811-30820 of 1611142 results.
ID: 30811
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 848750
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30812
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 848730
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30813
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 848734
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30814
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 848752
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30815
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1491624
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30816
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2468316
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 30817
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2381144
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30818
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 465355
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30819
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 979099
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30820
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 967023
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0