CMS Formulary

Displaying 28781-28790 of 1611142 results.
ID: 28781
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 314230
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28782
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 861646
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28783
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 861650
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28784
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 861654
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28785
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2123076
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 36
Qty Limit Days: 30
ID: 28786
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 349591
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28787
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 349592
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28788
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 349593
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28789
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1011736
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28790
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1011739
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0