CMS Formulary

Displaying 30961-30970 of 1611142 results.
ID: 30961
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 830470
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30962
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300310
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30963
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300206
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30964
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300191
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30965
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300468
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30966
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607808
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30967
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 797641
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30968
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2360588
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30969
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 807225
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30970
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1486496
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0