CMS Formulary

Displaying 28131-28140 of 1611142 results.
ID: 28131
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1551923
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28132
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601373
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28133
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1654079
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28134
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 853354
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28135
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 853356
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28136
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 848164
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28137
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653144
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28138
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482814
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28139
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1653166
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28140
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1100079
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30