CMS Formulary

Displaying 30911-30920 of 1611142 results.
ID: 30911
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 313852
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30912
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 106336
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 30913
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 543460
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30914
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197574
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 30915
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 309333
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 30916
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 855168
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30917
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198245
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30918
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1597076
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 30919
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 992441
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30920
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 992454
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0