CMS Formulary

Displaying 29541-29550 of 1611142 results.
ID: 29541
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 847745
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 29542
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1872980
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29543
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747577
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 29544
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747579
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 29545
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747567
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 29546
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747580
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29547
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921017
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29548
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921010
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29549
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921468
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29550
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 152971
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0