CMS Formulary

Displaying 29941-29950 of 1611142 results.
ID: 29941
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 801417
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29942
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 204520
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29943
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799890
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29944
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 800928
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29945
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 800812
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29946
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1189640
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29947
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 800933
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29948
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001321
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 29949
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1091843
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 29950
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 402091
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30