CMS Formulary

Displaying 28191-28200 of 1611142 results.
ID: 28191
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544388
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28192
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544390
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28193
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544394
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28194
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544396
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28195
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544398
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28196
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544402
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28197
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659818
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 28198
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1659814
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 28199
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658325
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 28200
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658329
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30