CMS Formulary

Displaying 29061-29070 of 1611142 results.
ID: 29061
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 199889
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29062
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 311486
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29063
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 904396
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 29064
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 199672
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29065
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 252559
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29066
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 239238
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29067
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 602393
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29068
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 432402
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 29069
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 477560
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29070
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 477562
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0