CMS Formulary

Displaying 30361-30370 of 1611142 results.
ID: 30361
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 763185
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30362
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 763183
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30363
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 861424
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30364
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1047040
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30365
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1047041
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30366
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1727569
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30367
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 403920
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30368
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 312068
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30369
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 314152
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30370
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 312071
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0