CMS Formulary

Displaying 28561-28570 of 1611142 results.
ID: 28561
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 581531
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28562
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371050
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 28563
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371054
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 28564
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371058
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 28565
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371062
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 28566
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2371066
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 28567
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482513
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28568
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482517
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28569
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482523
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28570
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1482527
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30