CMS Formulary

Displaying 29271-29280 of 1611142 results.
ID: 29271
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058877
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 29272
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1745108
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29273
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2395779
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 29274
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058887
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 29275
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2370174
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 29276
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2170613
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 30
ID: 29277
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2395785
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 29278
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2370170
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 29279
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047247
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29280
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2256947
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 30