CMS Formulary

Displaying 30981-30990 of 1611142 results.
ID: 30981
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 865208
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30982
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 865212
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30983
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 865216
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 30984
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 723827
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30985
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 729201
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30986
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 729203
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30987
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796079
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30988
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796083
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30989
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1433879
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30990
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1546894
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0