CMS Formulary

Displaying 28221-28230 of 1611142 results.
ID: 28221
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 616116
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 28222
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 616114
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 28223
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 643714
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 28224
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1429367
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 28225
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 643722
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 28226
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369724
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 28227
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369728
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 28228
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369732
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 28229
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369736
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 28230
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1940376
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30