CMS Formulary

Displaying 29931-29940 of 1611142 results.
ID: 29931
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197541
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 29932
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 753478
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29933
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 753479
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29934
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1428933
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29935
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091828
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29936
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 351173
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29937
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 351174
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29938
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 351175
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29939
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 794639
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 29940
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 616578
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30