CMS Formulary

Displaying 29581-29590 of 1611142 results.
ID: 29581
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310138
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 29582
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310144
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 29583
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310147
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 29584
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364114
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 29585
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364118
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 29586
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364122
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 29587
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653243
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29588
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1599797
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29589
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603361
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29590
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1603365
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0