CMS Formulary

Displaying 30351-30360 of 1611142 results.
ID: 30351
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 702519
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30352
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 314182
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30353
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 885219
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30354
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 885213
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30355
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049635
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 30356
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198086
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30357
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 199167
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30358
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 199164
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30359
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 763181
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30360
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 763179
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0