CMS Formulary

Displaying 29881-29890 of 1611142 results.
ID: 29881
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2170993
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 29882
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2173822
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 29883
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2395775
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 29884
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 249066
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29885
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 207840
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29886
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178081
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29887
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2178077
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29888
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 311671
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29889
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 995278
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 29890
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 995253
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0