CMS Formulary

Displaying 29501-29510 of 1611142 results.
ID: 29501
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099952
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 29502
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2105860
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 29503
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2469340
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29504
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 637188
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 336
Qty Limit Days: 365
ID: 29505
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 795735
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 336
Qty Limit Days: 365
ID: 29506
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 637190
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 336
Qty Limit Days: 365
ID: 29507
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 795737
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29508
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2284104
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 29509
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1741049
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29510
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2273115
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0