CMS Formulary

Displaying 28211-28220 of 1611142 results.
ID: 28211
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044969
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 28212
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044967
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 28213
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044971
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 28214
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649961
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 28215
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1550946
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28216
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 213360
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28217
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 404449
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28218
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 700418
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28219
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 404450
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28220
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1242233
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28