CMS Formulary

Displaying 30991-31000 of 1611142 results.
ID: 30991
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1857913
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30992
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1857917
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30993
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1857925
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30994
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989506
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30995
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2122526
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30996
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2380551
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30997
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2374566
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30998
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790146
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 30999
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197839
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 31000
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 313447
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0