CMS Formulary

Displaying 30881-30890 of 1611142 results.
ID: 30881
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 795749
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30882
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809520
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30883
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 239189
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30884
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665107
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30885
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 309072
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30886
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 863538
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30887
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665507
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30888
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 240209
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30889
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 318202
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 30890
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 238600
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0