CMS Formulary

Displaying 30861-30870 of 1611142 results.
ID: 30861
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 751566
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30862
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 751568
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30863
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 751570
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30864
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 897044
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30865
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 758032
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 30866
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 758027
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 30867
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650282
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30868
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 207836
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30869
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 796918
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30870
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649996
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28