CMS Formulary

Displaying 29371-29380 of 1611142 results.
ID: 29371
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 762839
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29372
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 762843
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29373
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 762875
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29374
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 762849
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29375
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 762852
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29376
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 762859
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29377
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 762868
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29378
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 762897
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29379
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1009341
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 25
ID: 29380
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1595462
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0