CMS Formulary

Displaying 29921-29930 of 1611142 results.
ID: 29921
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 993466
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29922
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 993470
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29923
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 993462
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29924
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047868
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 29925
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 834350
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29926
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801299
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29927
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 832731
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29928
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801295
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29929
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123111
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 29930
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198071
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0