CMS Formulary

Displaying 29781-29790 of 1611142 results.
ID: 29781
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 859835
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29782
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 905273
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29783
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1099687
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29784
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 312036
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29785
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 856940
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 2700
Qty Limit Days: 30
ID: 29786
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 834137
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29787
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 810002
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 29788
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 809990
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 29789
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 809994
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 29790
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 809998
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30