CMS Formulary

Displaying 28651-28660 of 1611142 results.
ID: 28651
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110780
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 28652
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110783
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 28653
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2110786
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 28654
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2183131
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 28655
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 866907
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28656
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2000133
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28657
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1801519
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 28658
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 539789
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 28659
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 856666
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 28660
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 979115
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28