CMS Formulary

Displaying 29221-29230 of 1611142 results.
ID: 29221
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 848343
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 84
ID: 29222
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665906
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 29223
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665900
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 29224
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801322
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 7
Qty Limit Days: 28
ID: 29225
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2262446
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 29226
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123034
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29227
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2274390
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 29228
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2282320
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 30
ID: 29229
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1591943
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 29230
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799212
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28