CMS Formulary

Displaying 28421-28430 of 1611142 results.
ID: 28421
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2204092
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 28422
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544471
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28423
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1544475
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28424
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1591949
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 28425
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2204104
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 28426
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2204102
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 28427
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1721619
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28428
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1747697
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28429
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1741739
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28430
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799218
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28