CMS Formulary

Displaying 28431-28440 of 1611142 results.
ID: 28431
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2288816
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 28432
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1858267
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28433
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1939335
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 28434
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1999673
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28435
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 315183
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28436
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 831226
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28437
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 831255
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28438
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 831309
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28439
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 831338
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28440
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 831196
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0