CMS Formulary

Displaying 29841-29850 of 1611142 results.
ID: 29841
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653204
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 28
ID: 29842
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 351926
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 40
Qty Limit Days: 28
ID: 29843
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 849851
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29844
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 847247
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29845
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 847348
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29846
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 847245
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29847
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197590
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 29848
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197591
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 29849
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197589
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 29850
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 197391
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0