CMS Formulary

Displaying 28531-28540 of 1611142 results.
ID: 28531
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1726639
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28532
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364362
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28533
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1364358
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28534
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2473042
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28535
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049271
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28536
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049278
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28537
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197518
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28538
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 284215
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28539
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 544840
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28540
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 313165
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28