CMS Formulary

Displaying 29301-29310 of 1611142 results.
ID: 29301
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1045404
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 29302
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364441
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 29303
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364447
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 29304
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1145932
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29305
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799230
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29306
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1925255
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29307
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1925257
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29308
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1598989
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29309
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601660
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29310
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992428
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0