CMS Formulary

Displaying 30901-30910 of 1611142 results.
ID: 30901
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 977990
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30902
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 977978
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30903
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 309289
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 30904
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 309291
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 19
Qty Limit Days: 30
ID: 30905
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 895487
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30906
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 895987
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30907
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 797274
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30908
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 310982
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 30
ID: 30909
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 313189
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 30910
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197362
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0