CMS Formulary

Displaying 30831-30840 of 1611142 results.
ID: 30831
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 562704
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30832
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 312849
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30833
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 997229
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30834
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 997223
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30835
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 993503
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30836
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 993518
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30837
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 898723
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30838
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 898687
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30839
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 898690
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30840
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 898719
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0