CMS Formulary

Displaying 28171-28180 of 1611142 results.
ID: 28171
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2392142
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28172
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 261105
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28173
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310531
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28174
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1310535
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28175
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1547231
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28176
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110618
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28177
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114074
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28178
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114096
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28179
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 903841
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28180
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1114470
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30