CMS Formulary

Displaying 28751-28760 of 1611142 results.
ID: 28751
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 724863
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28752
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 724859
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28753
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 724861
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28754
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 403818
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28755
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 897021
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28756
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2049264
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 84
ID: 28757
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1856424
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28758
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2052064
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28759
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 861375
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28760
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 861370
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0