CMS Formulary

Displaying 28661-28670 of 1611142 results.
ID: 28661
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244062
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 28662
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1244064
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 11
Qty Limit Days: 28
ID: 28663
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1596778
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28664
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1673274
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 28665
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1673278
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 28666
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1673280
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 28667
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1925264
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 56
ID: 28668
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049343
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 365
ID: 28669
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 312941
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28670
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 312938
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0