CMS Formulary

Displaying 29861-29870 of 1611142 results.
ID: 29861
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 213484
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29862
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 759473
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 180
ID: 29863
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 896185
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 29864
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 896212
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 29865
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 896229
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 29866
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 896237
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 29867
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 896245
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 29868
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 896273
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 29869
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 895996
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 29870
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 896001
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28