CMS Formulary

Displaying 30751-30760 of 1611142 results.
ID: 30751
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198382
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30752
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 997226
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30753
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 997220
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30754
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 349201
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30755
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 200034
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30756
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 312078
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30757
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 314154
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30758
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 283639
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30759
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 200284
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30760
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 312076
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30