CMS Formulary

Displaying 28091-28100 of 1611142 results.
ID: 28091
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2045638
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 28092
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2120195
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 28093
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123191
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 28094
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 727537
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28095
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648162
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28096
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1648160
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28097
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2048718
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28098
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2048722
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28099
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1991509
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28100
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1865962
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0