CMS Formulary

Displaying 30791-30800 of 1611142 results.
ID: 30791
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 311207
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30792
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198239
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30793
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198238
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30794
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1922720
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30795
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650143
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30796
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298910
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 30797
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298816
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 30798
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1298906
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 30799
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 858613
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30800
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 858616
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0