CMS Formulary

Displaying 28001-28010 of 1611142 results.
ID: 28001
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 404539
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28002
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1543069
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 28003
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1010878
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28004
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1085741
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28005
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1191302
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28006
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 310152
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 28007
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 2180999
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28008
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1716268
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28009
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 1921598
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 28010
Formulary ID: 00021008
Formulary Version: 14
Contract Year: 2021
RXCUI: 828348
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0