CMS Formulary

Displaying 29801-29810 of 1611142 results.
ID: 29801
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 859824
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29802
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 309101
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29803
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 835840
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29804
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 835809
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 28
ID: 29805
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649988
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29806
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 308189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29807
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 313797
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29808
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 239191
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29809
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665052
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29810
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665444
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0