CMS Formulary

Displaying 30871-30880 of 1611142 results.
ID: 30871
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650004
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 30872
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 582984
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30873
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122661
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30874
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122659
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30875
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122657
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30876
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122655
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30877
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122650
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30878
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122648
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30879
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122642
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30880
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2477272
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30