CMS Formulary

Displaying 30511-30520 of 1611142 results.
ID: 30511
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 312357
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30512
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 312362
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30513
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2106334
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30514
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1661220
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30515
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 854876
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30516
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 283672
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30517
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 200371
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30518
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 309314
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30519
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 859044
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30520
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 859048
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0