CMS Formulary

Displaying 29711-29720 of 1611142 results.
ID: 29711
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 995218
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29712
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 866090
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29713
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 643066
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29714
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1652084
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29715
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1006801
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 29716
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 996921
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 29717
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 721773
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 29718
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 476179
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 29719
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 476177
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 29720
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 199703
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0