CMS Formulary

Displaying 30741-30750 of 1611142 results.
ID: 30741
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197313
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30742
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 313566
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30743
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 485434
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30744
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 485436
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30745
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 859424
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30746
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 859747
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30747
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 859751
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30748
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 859419
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30749
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 199192
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30750
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 199193
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0