CMS Formulary

Displaying 28141-28150 of 1611142 results.
ID: 28141
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1918044
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 28142
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1928689
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28143
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2118741
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28144
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000019
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 28145
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1994362
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 28146
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1442992
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 28147
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000023
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 28148
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000027
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 28149
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000031
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 28150
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1300386
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0