CMS Formulary

Displaying 29111-29120 of 1611142 results.
ID: 29111
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2001439
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 29112
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1437713
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29113
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1918242
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 29114
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862595
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 29115
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921589
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 29116
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1862590
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 29117
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1666542
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29118
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 831246
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29119
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 849515
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29120
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 833008
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0