CMS Formulary

Displaying 28201-28210 of 1611142 results.
ID: 28201
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658333
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28202
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658337
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28203
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658341
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28204
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658345
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28205
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602604
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 28206
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1602607
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 28207
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2274816
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 28208
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2274814
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 28209
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044355
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 28210
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044357
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30