CMS Formulary

Displaying 28771-28780 of 1611142 results.
ID: 28771
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729065
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28772
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729013
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28773
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729029
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28774
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729033
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28775
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729047
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28776
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1729076
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28777
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2261800
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 28778
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799001
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28779
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1790317
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28780
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 727714
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0