CMS Formulary

Displaying 29081-29090 of 1611142 results.
ID: 29081
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 483448
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 29082
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 483446
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 29083
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 312515
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29084
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1795598
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29085
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1366192
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 29086
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1796922
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29087
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1744001
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29088
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1744005
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29089
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1744009
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29090
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243585
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0