CMS Formulary

Displaying 30031-30040 of 1611142 results.
ID: 30031
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 966249
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30032
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 892251
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30033
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 892255
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30034
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 966270
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30035
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 349477
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30036
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198324
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30037
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198325
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30038
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198323
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30039
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 855942
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 30040
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 313366
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0