CMS Formulary

Displaying 29241-29250 of 1611142 results.
ID: 29241
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 905057
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 168
ID: 29242
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1251334
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29243
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487076
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 224
Qty Limit Days: 28
ID: 29244
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1368459
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29245
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 751970
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29246
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 836358
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 312
Qty Limit Days: 30
ID: 29247
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191250
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29248
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 207373
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29249
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1245268
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 29250
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 314088
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0