CMS Formulary

Displaying 29601-29610 of 1611142 results.
ID: 29601
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 884619
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 29602
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2121061
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28
ID: 29603
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1656356
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29604
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1859501
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 29605
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1919094
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 224
Qty Limit Days: 28
ID: 29606
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2169314
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 29607
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2169322
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 29608
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2362240
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 29609
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2169320
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 29610
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2362244
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30