CMS Formulary

Displaying 30651-30660 of 1611142 results.
ID: 30651
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 213262
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30652
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 545259
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30653
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099503
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30654
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 850309
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30655
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 310015
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30656
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1150836
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30657
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2118539
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30658
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 864650
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30659
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 308511
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30660
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1375922
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0