CMS Formulary

Displaying 29291-29300 of 1611142 results.
ID: 29291
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 582971
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29292
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 582976
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29293
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1435117
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 29294
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 351859
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 29295
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1731317
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 28
ID: 29296
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 643177
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 29297
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 643173
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 29298
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 643175
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 29299
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 799830
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 29300
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1045408
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30