CMS Formulary

Displaying 29951-29960 of 1611142 results.
ID: 29951
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1986819
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 29952
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2289424
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 29953
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2289428
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 29954
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1942485
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 29955
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1942489
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 29956
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2047639
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 29957
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 2053927
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 29958
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721571
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 29959
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721583
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 29960
Formulary ID: 00021009
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989109
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28