CMS Formulary

Displaying 29071-29080 of 1611142 results.
ID: 29071
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373497
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29072
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 403875
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29073
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 310430
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 29074
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 310459
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29075
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 828320
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29076
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 314285
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29077
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 200311
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29078
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 310431
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 29079
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 728113
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 48
Qty Limit Days: 180
ID: 29080
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 483442
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30