CMS Formulary

Displaying 30171-30180 of 1611142 results.
ID: 30171
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 755497
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30172
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 992765
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30173
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 630208
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 30174
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 245314
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 30175
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 485968
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30176
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 991061
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30177
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 857683
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30178
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1000913
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30179
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198202
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30180
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 857677
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0