CMS Formulary

Displaying 29871-29880 of 1611142 results.
ID: 29871
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 896006
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 28
ID: 29872
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1539893
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 29873
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487528
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 29874
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547660
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 29875
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547672
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 29876
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1720606
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 29877
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648789
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 29878
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1945048
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 29879
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2045382
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 29880
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2109239
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0