CMS Formulary

Displaying 28591-28600 of 1611142 results.
ID: 28591
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1546189
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 28592
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2261794
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 28593
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1040058
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28594
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 858804
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28595
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 794641
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28596
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 617768
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28597
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790892
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28598
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790886
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28599
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790890
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28600
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2384465
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 28