CMS Formulary

Displaying 30601-30610 of 1611142 results.
ID: 30601
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198223
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30602
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 856364
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30603
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 863636
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30604
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 863619
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30605
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 863628
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30606
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 314080
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30607
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1190655
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30608
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 545236
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30609
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1724340
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30610
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 312075
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0