CMS Formulary

Displaying 29421-29430 of 1611142 results.
ID: 29421
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653579
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29422
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 198148
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29423
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797833
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 29424
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797844
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 10
ID: 29425
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 885857
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29426
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 860901
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 200
Qty Limit Days: 30
ID: 29427
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 351265
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 29428
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 351266
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 29429
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 351267
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 29430
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 905172
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0