CMS Formulary

Displaying 28601-28610 of 1611142 results.
ID: 28601
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1670324
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 80
Qty Limit Days: 28
ID: 28602
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1670322
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 28
ID: 28603
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 309952
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28604
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197622
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28605
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 309955
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28606
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1117531
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 50
Qty Limit Days: 30
ID: 28607
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1116758
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 25
Qty Limit Days: 30
ID: 28608
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1440936
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28609
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 309077
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28610
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 313428
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0