CMS Formulary

Displaying 30231-30240 of 1611142 results.
ID: 30231
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 577961
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30232
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 541363
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30233
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 751868
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30234
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 751871
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30235
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 751870
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30236
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 762007
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30237
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 751885
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30238
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 753481
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30239
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 762333
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30240
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 751890
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0