CMS Formulary

Displaying 29691-29700 of 1611142 results.
ID: 29691
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1148141
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 29692
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 861960
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 29693
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 905032
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 29694
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1090996
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29695
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197595
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29696
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197596
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29697
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 309958
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29698
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 309960
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29699
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 884707
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 29700
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 753543
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0