CMS Formulary

Displaying 29391-29400 of 1611142 results.
ID: 29391
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 904170
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29392
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 854859
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29393
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1859000
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 29394
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1604544
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 28
ID: 29395
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2002420
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 29396
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923338
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29397
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1923347
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29398
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876406
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29399
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2375329
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29400
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099302
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0