CMS Formulary

Displaying 30731-30740 of 1611142 results.
ID: 30731
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 351285
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30732
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123194
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 30733
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 313565
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30734
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 313564
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30735
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 199885
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30736
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 242438
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30737
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 200094
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30738
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 200095
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30739
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 200096
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30740
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197311
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0