CMS Formulary

Displaying 29321-29330 of 1611142 results.
ID: 29321
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243848
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 29322
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243843
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 29323
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1243833
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 29324
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 665044
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 29325
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 665040
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 29326
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 744846
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29327
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 665036
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 29328
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547114
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 29329
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547118
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 29330
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235595
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0