CMS Formulary

Displaying 30851-30860 of 1611142 results.
ID: 30851
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198038
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30852
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198039
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30853
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198040
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30854
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010600
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30855
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307056
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30856
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010604
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30857
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198182
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30858
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 351223
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 30859
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198070
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30860
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 401938
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30