CMS Formulary

Displaying 29791-29800 of 1611142 results.
ID: 29791
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 995156
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 29792
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 308963
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29793
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 317173
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29794
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 308964
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29795
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197604
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29796
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197606
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29797
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198089
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29798
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198083
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29799
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 314055
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29800
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1655960
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0