CMS Formulary

Displaying 29721-29730 of 1611142 results.
ID: 29721
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359129
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29722
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 485440
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 29723
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860157
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 29724
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860129
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 29725
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860137
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 29726
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860148
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 29727
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 835894
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29728
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 835925
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29729
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 241834
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29730
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1368954
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0