CMS Formulary

Displaying 30921-30930 of 1611142 results.
ID: 30921
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006688
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30922
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197785
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30923
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197803
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30924
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 798133
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30925
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 755470
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30926
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 544452
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30927
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 597768
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30928
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 597770
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30929
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 597772
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30930
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 403975
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0