CMS Formulary

Displaying 29121-29130 of 1611142 results.
ID: 29121
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 883826
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 29122
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197943
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29123
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197944
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29124
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659929
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29125
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2102705
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29126
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058906
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29127
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1872458
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 29128
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049133
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 29129
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049121
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 29130
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1855072
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30