CMS Formulary

Displaying 28841-28850 of 1611142 results.
ID: 28841
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490026
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 28842
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490034
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 28843
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1490038
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 28844
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 313580
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28845
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2257015
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 28846
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044720
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28847
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044726
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28848
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044732
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 28849
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046376
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28850
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2046380
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0