CMS Formulary

Displaying 29021-29030 of 1611142 results.
ID: 29021
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 748798
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29022
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989507
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29023
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876920
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 29024
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876924
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 29025
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876916
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 29026
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1111642
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 29027
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487363
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 29028
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 308725
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 420
Qty Limit Days: 30
ID: 29029
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 855657
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 29030
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812011
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0