CMS Formulary

Displaying 28581-28590 of 1611142 results.
ID: 28581
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1926823
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28582
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1926827
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 30
ID: 28583
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1809513
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28584
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876671
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28585
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876673
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28586
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1876674
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28587
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1812434
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28588
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 866111
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28589
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 198252
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28590
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649593
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28