CMS Formulary

Displaying 28621-28630 of 1611142 results.
ID: 28621
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2399901
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 28622
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 198013
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28623
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 198012
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28624
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797113
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 28
ID: 28625
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2399904
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 28626
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098141
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28627
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1098134
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28628
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 577033
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 28629
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 995624
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28630
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2266506
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28