CMS Formulary

Displaying 28821-28830 of 1611142 results.
ID: 28821
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 616483
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 28822
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 312743
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 28823
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 312840
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 28824
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 314209
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 28825
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 199206
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28826
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197805
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28827
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197806
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28828
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197807
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28829
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 311347
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28830
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 311204
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0