CMS Formulary

Displaying 28761-28770 of 1611142 results.
ID: 28761
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373745
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28762
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 485442
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28763
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 485465
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28764
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 352066
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28765
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 656660
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28766
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1989085
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 28767
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1442143
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28768
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729053
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 28769
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729057
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28770
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729061
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30