CMS Formulary

Displaying 28571-28580 of 1611142 results.
ID: 28571
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1235249
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28572
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040036
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28573
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1431237
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28574
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040043
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28575
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1297357
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28576
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1356693
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28577
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1442681
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28578
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1442683
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28579
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2101459
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28580
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2101465
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0