CMS Formulary

Displaying 29441-29450 of 1611142 results.
ID: 29441
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 897657
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 29442
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1049604
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1300
Qty Limit Days: 30
ID: 29443
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1874559
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 29444
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1874553
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 29445
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 900575
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29446
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 977427
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29447
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 977434
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29448
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 977438
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29449
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 892625
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 29450
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 311355
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0