CMS Formulary

Displaying 30501-30510 of 1611142 results.
ID: 30501
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197738
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30502
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 311725
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30503
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 311726
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30504
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 884386
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 30505
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 884385
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 30506
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 993770
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 30507
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 993890
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 30508
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 864718
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 30509
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197593
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30510
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 199168
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0