CMS Formulary

Displaying 30571-30580 of 1611142 results.
ID: 30571
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 312441
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30572
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 199123
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30573
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197956
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30574
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197958
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30575
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 200064
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30576
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 199224
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30577
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 313190
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30578
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198377
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30579
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198378
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30580
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1483744
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0