CMS Formulary

Displaying 30661-30670 of 1611142 results.
ID: 30661
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 204423
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30662
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 310687
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30663
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 314165
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30664
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 226343
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30665
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191013
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30666
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 308493
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30667
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1116150
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30668
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 310594
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30669
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 905379
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30670
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790533
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30