CMS Formulary

Displaying 29971-29980 of 1611142 results.
ID: 29971
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 861043
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 28
ID: 29972
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 206347
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29973
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 801357
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29974
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 801112
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29975
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 801136
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29976
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799706
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29977
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 805131
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29978
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 801648
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29979
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 800420
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29980
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 800405
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0