CMS Formulary

Displaying 30781-30790 of 1611142 results.
ID: 30781
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197703
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30782
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300783
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30783
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 831261
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30784
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 829500
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30785
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 861025
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 765
Qty Limit Days: 30
ID: 30786
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 881341
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30787
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 199690
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30788
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197417
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30789
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197418
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30790
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197419
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0