CMS Formulary

Displaying 29251-29260 of 1611142 results.
ID: 29251
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 403914
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29252
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 885209
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29253
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1922765
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29254
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1922763
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29255
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 105553
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29256
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 105590
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29257
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364498
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 45
Qty Limit Days: 30
ID: 29258
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364490
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 29259
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364494
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 29260
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648772
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30