CMS Formulary

Displaying 29571-29580 of 1611142 results.
ID: 29571
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2056897
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29572
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 746609
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 29573
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 845518
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 29574
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 845512
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 29575
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 847734
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29576
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 860244
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 29577
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1002300
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 29578
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 998191
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 29579
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1012899
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 29580
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1119402
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28