CMS Formulary

Displaying 29191-29200 of 1611142 results.
ID: 29191
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2275613
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 29192
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272118
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 29193
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272122
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 29194
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2272126
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 29195
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2394947
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 29196
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2199304
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29197
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2199308
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29198
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2199312
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29199
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2199316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29200
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 206883
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0