CMS Formulary

Displaying 30121-30130 of 1611142 results.
ID: 30121
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 239209
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30122
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1807518
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30123
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860139
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30124
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 800192
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30125
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665021
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30126
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 309090
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30127
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 309092
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30128
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665005
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30129
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 311683
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30130
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 727575
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0