CMS Formulary

Displaying 30951-30960 of 1611142 results.
ID: 30951
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1307061
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30952
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1115698
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 180
ID: 30953
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1308569
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30954
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 351209
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30955
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197623
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30956
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055650
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 30957
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099808
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30958
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1484296
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30959
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190919
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30960
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244205
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0