CMS Formulary

Displaying 28971-28980 of 1611142 results.
ID: 28971
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054983
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 28972
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055016
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 28973
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055014
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 28974
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 197701
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28975
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 310433
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 28976
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 310434
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 28977
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 403966
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28978
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 403967
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28979
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1358776
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28980
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 309367
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0