CMS Formulary

Displaying 29741-29750 of 1611142 results.
ID: 29741
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 403879
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 29742
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 476556
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29743
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197535
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 29744
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 310295
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 29745
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 310297
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 29746
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 313992
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 29747
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 313993
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 29748
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 310293
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 29749
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 310294
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 29750
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 314000
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0