CMS Formulary

Displaying 30301-30310 of 1611142 results.
ID: 30301
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198076
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30302
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198077
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30303
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198078
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30304
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198075
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30305
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 313472
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 30306
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198153
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30307
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 905269
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30308
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 905283
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30309
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198152
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30310
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 312615
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0