CMS Formulary

Displaying 28241-28250 of 1611142 results.
ID: 28241
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123137
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28
ID: 28242
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123141
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 28243
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123145
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 28244
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1102277
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28245
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 794610
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28246
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 831870
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28247
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 850457
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28248
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1236632
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28249
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1359271
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28250
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 758555
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0