CMS Formulary

Displaying 29491-29500 of 1611142 results.
ID: 29491
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2058922
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 29492
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2103175
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 29493
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2103179
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 29494
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 810075
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29495
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 810079
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29496
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2284108
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 29497
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2057205
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29498
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2057216
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29499
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2057212
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29500
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2057219
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0