CMS Formulary

Displaying 30701-30710 of 1611142 results.
ID: 30701
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 152695
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30702
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 854905
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30703
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 854901
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30704
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 313762
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30705
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 313761
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30706
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 884173
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30707
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 884185
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30708
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 884189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30709
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099625
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30710
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 996571
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30