CMS Formulary

Displaying 28231-28240 of 1611142 results.
ID: 28231
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1940372
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28232
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2197501
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 28233
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2396770
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 28
ID: 28234
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2396774
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 28
ID: 28235
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2288433
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28236
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2288412
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28237
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2288431
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28238
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 727816
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 28239
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1650901
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 28240
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054995
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 7
Qty Limit Days: 7