CMS Formulary

Displaying 28011-28020 of 1611142 results.
ID: 28011
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369831
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30
ID: 28012
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870950
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28013
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870956
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28014
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870952
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28015
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870960
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28016
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1870968
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 28
ID: 28017
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1304985
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 28018
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1811182
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 28019
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649405
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28020
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 313096
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0